Healthcare stakeholders can impact a patient’s health by leveraging available capabilities and resources to help achieve better health outcomes and address this opioid epidemic.
Taking the life of a U.S. citizen every 13 minutes, the opioid epidemic continues to devastate our country and overwhelm our communities, neighbors, coworkers, friends, and family members. This national health crisis places an undue burden on the entire healthcare system, negatively impacting health outcomes and causing significant financial strain.
While it’s well-documented that these medications remain overprescribed, opioids represent very effective options for managing pain for select chronic medical conditions like cancer and end-of-life care, and in short-term treatment of more severe acute pain where alternative therapy may not be suitable. Despite the attention drawn to the epidemic and the excess supply of these medications on the market today, we must also remain conscientious of the large numbers of patients with chronic, debilitating pain who rely on opioids to improve their quality of life and overall function, and ensure appropriate access to viable, effective, non-opioid treatment alternatives.
Opioids are powerful medications with highly addictive potential, and anyone taking them, regardless of predisposition to addiction, can find themselves struggling with reliance and dependence. An estimated 2.1 million Americans suffer from ‘documented’ opioid use disorder, according to the Substance Abuse and Mental Health Services Administration. Further, data shows the economic cost of the opioid crisis, including treatment, was $504 billion in 2015.
Given the depth and breadth of this crisis, virtually all constituents of the healthcare system hold some level of responsibility in utilizing tools and resources at their disposal to help address this epidemic. To be successful, solutions must be multidimensional, mixing evidence-based clinical programming, educational outreach, and aggressive intervention in order to curb overuse, misuse and abuse, and to protect the safety of those requiring opioid therapy. Efforts must address every step of the process and target all stakeholders including patients, pharmacists/pharmacies and physicians. The most effective actions will address the contributing factors at the epidemic’s core, with tactics spanning several components, such as:
A plan in action
As a pharmacy care services company, OptumRx is focused on improving health outcomes and lowering total healthcare costs. Through implementing tools such as advanced data analytics, prior authorization requirements, and fraud monitoring strategies, OptumRx has achieved a significant degree of success through its Opioid Risk Management Program. For example, health plans and employer clients who have adopted the program saw significant reductions in opioid prescriptions and average daily opioid dosing, facilitating greater compliance by physicians and other prescribers with opioid prescribing standards set by the CDC. Positive results since the program’s launch include a 31% reduction in opioids prescribed, and a 34% reduction in total doses dispensed. Most importantly, in a recent analysis conducted by OptumRx and Optum Labs, clients who deployed such programming witnessed a 50% lower likelihood of patients progressing from short-term acute use to longer-term chronic opioid use.
As an industry and a country, we’re collectively taking steps in the right direction and the results we’ve seen have been encouraging. The current administration has passed new legislation that would help reduce the supply of highly addictive substances, like fentanyl, while creating incentives for using non-opioid pain treatments to improve quality of outcomes. A recentreport
from the American Medical Association shows the number of opioid prescriptions decreased by more than 22% between 2013 and 2017, with a 9% decrease between 2016 and 2017 alone.
While progress continues to be made, ending the opioid epidemic is a process, and will require collaborative action amongst multiple stakeholders across the health care continuum and beyond-including care providers, pharmacists, governments, clients, individual consumers, and community organizations-with the ultimate goal of protecting our citizens, while still preserving the highest quality in health outcomes for all.
David Calabrese, RPh, MHP, is senior vice president and chief pharmacy officer of OptumRx. He also is an editorial advisor for Managed Healthcare Executive.