Scott Gottlieb, M.D., commissioner of the Food and Drug Administration, said he wants insurers and pharmacy benefit managers to help curb opioid prescriptions.
Gottlieb told Bloomberg that payers and PBMs could help control opioid dispensing. That could mean changing labels and mandatory training for doctors on writing long-term prescriptions.
The agency’s focus on opioids has been one of the biggest changes since Gottlieb was appointed to the post by President Donald Trump earlier this year. He said the FDA is looking at a number of options that could reduce opioid prescribing or reduce the length of time patients take the drugs.
“I’m looking at different models that could potentially be less burdensome but be more effective at achieving the goal of making sure that prescribing conforms more closely with clinical guidelines,” Gottlieb said. “They’re not in there right now. There’s no information in the drug label about what the appropriate dispensing should be.”
Insurers have taken heat from addiction experts for rules governing how, and if, they cover substance-abuse treatment. Rules like prior authorization can keep opioid addicts waiting days or even weeks for opioid treatments, opening the door for potential relapse.
But experts say payers could do a number of things to curb the epidemic, and that they should be eager to play a role in response to the crisis, as they pay for both opioid prescriptions and addiction treatment.
PBMs, for instance, could require prior authorization for opioid prescriptions while payers remove those barriers to abuse treatments, said Andrew Kolodny, M.D., senior researcher at the Heller School of Social Policy and Management at Brandeis University.
Health insurers in Massachusetts are also countering the opioid epidemic by hiring social workers to support recovering addicts. In addition to helping people who need addiction treatment, supports like these could save payers significant amounts of money.
Opioid prescribing continues to be a massive problem for the entire healthcare system; the Centers for Disease Control and Prevention found that the number of prescriptions for opioids has tripled since 1999.