Comparing coverage policies for opioid, non-opioid back pain medication — 5 takeaways


Insurers can redesign back pain medication coverage policies to improve pain management and reduce opioid-related injuries and deaths, according to a study in JAMA Network Open.

Here are five things to know:

1. The study authors assessed medication coverage policies for 30 prescription opioids and 32 nonopioid analgesics used to treat chronic, non-cancer, low back pain in a cross-sectional study of health plan documents from 15 Medicaid, 15 Medicare Advantage and 20 commercial health plans.

2. The researchers also conducted 20 interviews with more than 43 senior medical and pharmacy health plan executives from representative plans.

3. Medicaid plans covered a median of 19 opioids and 22 nonopoids examined; Medicare Advantage plans covered a median of 17 opioids and 22 nonopioids examined; and commercial health plans covered a median of 23 opioids and 26 nonopioids examined.

4. Utilization management strategies were common for opioids in all plan types and usually relied on 30-day quantity limits rather than prior authorization. Many of the nonopioids examined were also subject to utilization management, especially quantity limits and prior authorization.

5. Informant interviews demonstrated an emphasis on increasing opioid utilization management and identifying high-risk patients and prescribers rather than promoting comprehensive strategies to improve chronic pain treatment.

More articles on spine:

Dr. Paul Eichenseer to join OrthoNeuro: 3 notes

9 thoughts on the future of innovation in spine from Dr. Frank Phillips

US News: Top 25 hospitals for pediatric neurology and neurosurgery

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers