Aetna puts opioid 'superprescribers' on notice

Medication adherence tool

In an effort to address the root of the opioid abuse crisis, Aetna has notified 931 doctors they prescribe painkillers in the top 1 percent of all doctors in the network, according to an article in the Washington Post.

The “superprescribers” dished out more than 1,500 more painkiller pills than the national average. Prescribing in line with the national average would have resulted in 1.4 million fewer pills dispensed by pharmacists annually, according to the news outlet. Still, as many as 280 million opioid prescriptions are filled annually.

After combing through claims data, Aetna sent notes to outlier doctors who were refilling prescriptions at much higher rates than their peers. The insurer does not want to tell physicians how to practice, but it does hope to show them data on quality of care, which includes prescriptions filled, and let them make the best care decisions from there, a spokesman told the Post.


2019 Drug Pricing and Reimbursement Stakeholder Summit

Given federal and state pricing requirements arising, press releases from industry leading pharma companies, and the new Drug Transparency Act, it is important to stay ahead of news headlines and anticipated requirements in order to hit company profit targets, maintain value to patients and promote strong, multi-beneficial relationships with manufacturers, providers, payers, and all other stakeholders within the pricing landscape. This conference will provide a platform to encourage a dialogue among such stakeholders in the pricing and reimbursement space so that they can receive a current state of the union regarding regulatory changes while providing actionable insights in anticipation of the future.

None of the doctors Aetna sent notes to also belonged to the list of doctors suspected of fraud in opioid prescribing, according to the Post.

Aetna’s decision is the latest in a string of efforts by insurers to curb opioid abuse. Cigna joined forces with the American Society of Addiction Medicine to use claims data to develop measures of the use of pharmacotherapy for opioid abuse and follow-up after withdrawal management.

Blue Shield of California set a goal to reduce opioid prescriptions by 50 percent in a three-year period, and other insurers have hired social workers to work with high-risk members.

- read the Washington Post article

Suggested Articles

Health insurers’ financial performance is on a continuing upward trend, but political and legal risks could pose a threat to that growth.

Senate lawmakers released a draft package of legislation Thursday aimed at curbing health care costs they said they believe they can pass on a bipartisan basis…

Attorneys general seeking to defend the ACA argue that their opponents—including the DOJ—have poor legal standing to challenge the law.