Nearly a quarter of patients on Medicaid filled a prescription for an opioid painkiller in 2015, according to a new report.
Express Scripts, a pharmacy benefits management firm that is one of the largest managers of Medicaid drug benefits in the country, analyzed data on 1.8 million opioid prescriptions given to 3.1 million Medicaid enrollees in 14 states. It found that 6% of all Medicaid prescriptions were for opioids. Of those that acquired opioids, nearly one-third took the medications for more than 30 days.
Opioids also contributed notably to costs, accounting for 4.1% of plan costs overall. Medicaid enrollees are 10 times more likely to be drug addicts or substance abusers than the general population, according to the report.
Medicaid members between the ages of 45 and 64 were the most likely to fill an opioid prescription, with just over 31% acquiring the drugs. Members in that age bracket also used opioids at the highest rate, filling an average of 5.4 opioid prescriptions per year, according to the report. Just over 4% of Medicaid enrollees aged 19 and under were on an opioid medication, according to the report.
Women were also far more likely to fill an opioid prescription, with 63% of women and 37% of men doing so. Opioid use was high among aged, blind and disabled and long-term care enrollees, and highest among Temporary Assistance for Needy Families members, with opioid use at about 6% in that population.
Other recent research has delved into the impact of the opioid crisis on Medicaid enrollees. In 2012 alone, Medicaid paid more than $500 million for 34 million claims for the drugs. Data like this can inform policymakers seeking solutions to the crisis.
Express Scripts offered several potential avenues for a solution in its analysis. Its report highlighted that this population is prescribed opioids in fairly high numbers, and also often from multiple providers and pharmacies. Steps to control “doctor shopping” to acquire opioids should be at the forefront of discussion, it said.
The company also suggested looking into medications designed to prevent dose form changes—and to prevent being crushed or dissolved for an injection. It also recommended looking for medications that block the euphoric effects of painkillers that lead to abuse.
As the epidemic continues, debates on funding will be at the forefront of health reform efforts in the political arena. Addiction medicine experts have expressed concern about the impact deep cuts to Medicaid, as proposed in both the House and Senate as part of steps to repeal and replace the Affordable Care Act, as the Medicaid expansion population is vulnerable to substance abuse.
The Senate’s version of the bill includes $2 billion in funding to combat the opioid crisis, falling far short of what some GOP senators hoped: $45 billion over 10 years. Senators representing states hit the hardest by opioid addiction are wary about this lack of funding in tandem with slashing Medicaid, reported The Wall Street Journal (sub. req.).
“I continue to have real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic,” Sen. Rob Portman, R-Ohio, said in a statement.
I continue to have concerns abt Medicaid policies in this draft bill, especially those that impact drug treatment:https://t.co/VXltVhg5h7— Rob Portman (@senrobportman) June 22, 2017
It’s likely that these on-the-fence senators will push hard on the opioid issue in the days ahead of next week’s planned vote. The GOP can only afford to lose two votes if it wants to pass the bill through budget reconciliation.