The healthcare industry is already following some best practices for prescribing opioids, but there are areas where it must improve in order to curb painkiller addiction and misuse, according to a new study.
The study, produced by America’s Health Insurance Plans, analyzed claims data from 2009-2013 to create an initial baseline that AHIP will then use to measure the ongoing progress of its Safe, Transparent Opioid Prescribing (STOP) Initiative.
“We can’t truly measure our progress until we know where we’re starting,” said Chief Medical Officer Richard Bankowitz, M.D. “These initial results will help ensure we’re making a meaningful and measurable impact as we work hand-in-hand with hospitals, physicians, patients and their families to stop this epidemic.”
On the plus side, the trade group found that 97% of initial opioid prescriptions for chronic pain were for immediate-release opioids during the period studied—a practice that adheres to the Centers for Disease Control and Prevention’s recommendations.
In addition, only 0.3% of patients have been starting their acute pain opioid management with an extended-release opioid. That indicates “strong alignment” with the CDC’s recommendation that clinicians should prescribe immediate-release opioids, rather than extended-release versions, when starting a patient on opioids.
However, 25% of initial prescriptions for opioids exceeded 50 MME (morphine milligram equivalent), indicating there is “room for improvement to reduce dosages,” per the analysis.
Another concerning finding was that 40% of chronic pain patients were prescribed benzodiazepines—a class of psychoactive drugs—during their opioid treatment, which the CDC has advised can be unsafe for patients.
Further, about 52–57% of patients did not have an “evaluation and management code” in their medical claims within 30 days of their initial opioid prescription. This suggests that providers could do better at following up with patients to ensure that the benefits of the opioid outweigh any potential harms.
AHIP says health plans can use its STOP Measure methodology to assess their own opioid prevention and management efforts. Insurers are indeed already taking a variety of steps to address the epidemic, such as implementing prescribing limits for certain opioids, investing in community health initiatives and easing access to addiction treatment medications.
However, some believe that insurers’ drug-pricing policies might actually be fueling the epidemic by limiting access to less-addictive pain medications while providing easier access to cheaper but more addictive generic opioid medications.