Webinar highlights opioid challenge from multiple angles
Team presentation brings clarity to complex issue
“Opioids are now deadlier than car crashes.”
That’s how Joe Chamberlin, director of consultant engagement, kicked off Prime Therapeutics’ (Prime’s) latest webinar. On Nov. 10, consultants across the U.S. tuned in to “Managing Opioids: Use Without Abuse.” The session offered insight into the crisis — and how consultants can help their clients find the right strategies to manage misuse.
A runaway epidemic
The roots date back to the 1970s. As drugmakers ramped up marketing, pain relief became a higher medical priority. And it hasn’t slowed down. Congress declared the 2000s the “decade of pain control and research.” Opioids led the pack.
As opioid use went up, so did misuse. In 2014, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Care Control and Prevention (CDC) declared it a public health emergency. In 2016, after a string of celebrity deaths, awareness reached new levels.
In 2016, the government took action with the Comprehensive Addiction & Recovery Act (CARA). The law spans prevention, law enforcement, treatment and criminal justice reform. It also includes recovery and overdose reversal. Well-intentioned but underfunded is how Angela Pope, Prime’s principal government affairs consultant, described it.
Curbing the crisis
Dr. Cathy Starner, principal health outcomes researcher, outlined how Prime is tackling opioid abuse. The primary challenges are:
- Identifying misuse and abuse.
- Stopping and preventing it.
- Controlling costs while serving member needs.
Prime’s addressing these challenges in multiple ways. We start by looking for tell-tale member behaviors such as:
- Risky drug combinations
- Doctor and pharmacy “shopping”
- Filling large supplies in short timeframes
- Extended use
After we dive into the data to find opportunities, we take action. This combination of analysis and action has generated positive results. Last year, Prime saw a 26% decrease in opioid abuse1.
The future of opioid management
The webinar wrapped up with a look into the future. Joe, Angela and Cathy reviewed new technologies and possible government actions. They highlighted the new class of long-acting opioids described as “abuse-deterrent.” The irony in this description is that the safeguards offered by these drugs can be sidestepped.
In addition to describing intended safeguards and limitations, the team also reviewed the potential cost impact of these drugs. Long-acting, abuse-deterrent opioids are expensive. They cost much more than the generic, short-acting opioids most common today. If mandated at the state or federal level, Prime estimates drug spend could increase as much as $2 per member per month (PMPM).
The team closed with three conclusions:
- Stemming the opioid crisis requires the engagement of multiple stakeholders.
- Plan sponsors have a wide variety of tools available to help address opioid abuse.
- Abuse-deterrent technologies are gaining traction. But they could have a big impact on drug spend and trend with unknown value.
1 - Abuse defined as >120mg morphine equivalent dosing for 60 consecutive days with 3 or more providers and 3 or more pharmacies
About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and delivers medicine to members, offering clinical services for people with complex medical conditions. Headquartered in St. Paul, Minn., Prime serves just over 22 million people. It is collectively owned by 14 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. Prime has been recognized as one of the fastest-growing private companies in the nation.
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