July 20, 2017
Prime Therapeutics urges caution on mandates of abuse-deterrent formulations of opioids citing value concerns
With so many lives at stake, policy makers and the health care industry need to stay focused on backing comprehensive, evidence-based solutions.
ST. PAUL, MINN. – Prime Therapeutics LLC (Prime) released this statement from its Chief Medical Officer, Jonathan Gavras, M.D., following today’s Institute for Clinical and Economic Review’s (ICER) public meeting reviewing its report on the effectiveness and value of abuse-deterrent formulations (ADF) of opioids. Prime was the sole pharmacy benefit manager on the policy roundtable at the meeting.
“The ICER data suggests there is not a material cost benefit to the use of abuse-deterrent formulations (ADF) in opioids in terms of overall cost vs. abuse-deterrent capability that they provide. We at Prime Therapeutics (Prime) believe opioids play an important role in pain management; however, we remain concerned about overprescribing of ADF opioids, especially when they can still be used in excess quantities and for illegitimate means. The fact is these products have not shown that they materially improve outcomes. If laws mandate ADFs over traditional opioids it will add billions of dollars to the U.S. health care system with limited benefits, and may even lead to unintended negative consequences of alternative narcotic abuse. While Prime supports ADF technology, these formulations alone are not going to solve the epidemic, and thus shouldn’t consume a disproportionate amount of the dollars to address the epidemic, which will happen if their use is mandated. With so many lives at stake, policy makers and the healthcare industry need to stay focused on backing comprehensive, evidence-based solutions.”
The voting body at the public meeting concluded:
- There was not enough evidence to demonstrate a reduced risk of abuse for people using immediate-release ADF RoxyBondTM over a non-ADF immediate release opioid.
- There was enough evidence of reduced risk of abuse to support using the extended-release ADF OxyContin® over its non-ADF opioid counterparts, but there was not enough evidence to support using other extended release ADF opioids.
- There was not enough evidence to demonstrate a net health benefit on a population level with the use of Oxycontin® vs. non-ADF extended release opioids.
- That the most appropriate public policy to pursue is to develop a way for physicians to work with payers, policy makers and addiction treatment centers to target ADFs to the highest risk people to help guide the prescriber in their decision making
For details on the questions and results visit @icer_review on Twitter.
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. Prime serves more than 20 million people. It is collectively owned by 14 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans.
Follow @Prime_PBM on Twitter.
Director, Corporate Communications