A 13% decline in the past year continues downward. Some of the decline might be explained by pandemic-related drop in healthcare utilization.
The opioid epidemic is hardly over, but Prime Therapeutics, the PBM for 23 Blues plans, is seeing notable declines in a number of measures of opioid prescribing among its claims.
In a review of it claims data from 16 million commercial members over the past year, Prime found a 13% decline in the number of members with an opioid claim and a similar reduction (12%) in members with a prescription for a high dose of opioids (90 morphine milligram equivalents or above).
“Obviously it is a good thing, we think, if there are fewer people getting opioids prescribed to them, because there are just a few instances when you actually need an opioid for pain control,” Cathy Starner, Pharm.D., health outcomes consultant senior principal, said in a recent interview with MHE.
Starner said the decline in opioid prescriptions be partly because of the pandemic-related decline in healthcare utilization, which was particularly steep during April and May of last year. But she also noted that the decline in opioid prescriptions among Prime’s claim goes back several years, so the recent decline is part of longer-term trend.
Prime has also seen a decline in its claims in the average days’ supply of opioids, from 16 to 15 days.
“Instead of you getting the seven-day supply day, when you are getting 50 tablets or whatever might be, you are getting 20 tablets for a three-day supply,” said Starner.
Prime, which is headquartered in Eagan, Minnesota, a Twin Cities suburb, has several programs designed to curb excessive and potentially harmful opioid prescribing, including utilization management at the point of sale. “If you are getting aprescription for the first tine and you don’t have any claims in your history, you probably don’t need a high dose or a large supply of an opioid,” Starner said.
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen
Mental Health Comorbidities Affect Uptravi Prescribing for PAH
October 23rd 2024New real-world data suggest that physicians are cautious about prescribing the prostacyclin-receptor agonist Uptravi (selexipag) to pulmonary arterial hypertension (PAH) patients with mental health conditions when evidence suggests that it is best to take a proactive approach to treating PAH.
Read More
In our latest "Meet the Board" podcast episode, Managed Healthcare Executive Editors caught up with editorial advisory board member, Eric Hunter, CEO of CareOregon, to discuss a number of topics, one including the merger that never closed with SCAN Health Plan due to local opposition from Oregonians.
Listen
High-Dose Eylea Shows Unique Properties in nAMD and DME | AAO 2024
October 22nd 2024A new statistical models shed light on why some patients can extend the dosing interval with Eylea (aflibercept) from 8 weeks to as long as 20 weeks for neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME).
Read More