2. Aetna’s opioid “super-prescribers” programs
Aetna uses claims data to detect concerning patterns and provide education and actionable data to clinicians so that they can make more educated choices about opioids.
One of Aetna’s most unique initiatives launched in 2016, when it sent letters to nearly 1,000 doctors in various specialties who were identified as “super-prescribers,” or who prescribed opioids at higher rates than their peers. The letters informed physicians that they were in the top 1% of opioid prescribers. The goal was to start a dialogue about their prescribing habits.
In 2017, the company continued its outreach by sending letters to 480 super-prescriber dentists and 249 oral surgeons. “Dentists were considered super-prescribers if they wrote more than four prescriptions for more than a seven-day supply over the past two years, based on Aetna’s claims data,” says spokesperson Ethan Slavin. “Oral surgeons, who typically treat more severe conditions, were considered super-prescribers if they wrote more than five prescriptions for more than a seven-day supply over the past year.”
Since August 2016, Aetna has seen a 7% reduction in monthly opioid prescriptions among its commercial pharmacy membership, and a 5% reduction in monthly opioid prescriptions among its Medicare Advantage pharmacy membership.
“The decrease in prescriptions are a result of several companywide efforts (including the ‘super-prescriber’ programs) to fight the opioid epidemic in the United States,” Slavin says. Other efforts include Aetna’s commitment to addressing prescription drug fraud and overprescribing, supporting e-prescribing for controlled substances, strengthening prescription drug monitoring programs, and studying best practices.
“Aetna is using its considerable data resources to help clinicians understand how their prescribing patterns compare to their peers and to established guidelines,” Slavin says. “This will enable them to reduce misuse and abuse and prevent the diversion of unused pills, which represents a major driver of the opioid epidemic.”