Attorneys generals from 37 state sent a letter to the health insurance industry on Monday asking its members to reconsider controversial coverage policies which could be inadvertently fueling the American opioid crisis.
Covered by ProPublica and The New York Times on Sunday, the request is part of an ongoing investigation by state prosecutors and officials to determine the causes of the opioid epidemic – as well as which parties should be considered most culpable.
ProPublica and the Times reported that many health insurance companies in the United States limit access to pain medications which purportedly carry a low risk of addiction or dependence, even while approving riskier, opioid-based alternatives.
The latter, while less likely to leave users craving more, cost insurance companies responsible for covering the cost of patients’ pills less than the former.
In a letter to America’s Health Insurance Plans – the main trade group representing the broader healthcare insurance industry – the attorneys general asked insurers to revise their rules “to encourage healthcare providers to prioritize non-opioid pain management options over opioid prescriptions for the treatment of chronic, non-cancer pain.”
“The status quo, in which there may be financial incentives to prescribe opioids for pain which they are ill-suited to treat, is unacceptable,” read the letter. “We ask that you quickly initiate additional efforts so that you can play an important role in stopping further deaths.”
Among the letter’s signatories are the attorneys general for the states of California, Florida, New York, Pennsylvania, and Michigan.
and I am now forced to be on stronger pain meds after dealing with out of control pain for weeks. How is this ok?
— Alisa Erkes (@alisa2089) April 27, 2017
Alisa Erkes, who was interviewed by the New York Times, said she was refused access to a more effective painkiler — and forced onto opioid medications — because her insurance wouldn’t pay more for the better and less addictive option.
Nearly 2 million Americans are estimated to abuse opioids, with the consequence being that drug overdoses are now the leading cause of death among Americans under the age of 50.
ProPublica notes that, while investigations have typically cast scrutiny on the role of drug makers, pharmacies, and doctors in prescribing and distributing opioids, less attention has been given to the enabling actions of insurance companies.
Now, the Department of Health and Human Services is launching its own inquiry, the aim of which is determine if insurers make opioids more accessible to patients suffering from pain than other equally effective medications.
In an open statement written to and published by ProPublica, Cathryn Donaldson, a spokeswoman for America’s Health Insurance Plans, said, “We share the state attorneys general’s commitment to eradicating the opioid epidemic in America.”
“Health plans cover comprehensive, effective approaches to pain management that include evidence-based treatments, more cautious opioid prescribing, and careful patient monitoring,” she wrote in her statement. “Recent research shows that non-opioid medications, even over-the-counter medication like ibuprofen, can provide just as much pain relief as opioids.”
Despite reassurances from the insurance industry, an analysis by the Times and ProPublica suggests that insurance providers seem reluctant to accept more expensive but less addictive physician prescriptions over inexpensive opioids.
“Everyone – including and especially insurance companies – have an obligation to address the opioid epidemic,” said New York Attorney General Eric Schneiderman. “Insurers must take a hard look at the systematic problems in our healthcare system that result in the over-prescription of opioids and fuel the cycle of addiction.”