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Effective Rx thwarted for deadly opioid epidemic
Date:6/21/2013

They're shown to decrease the frequency and quantity of drug use, withdrawal and craving, infectious diseases, criminal behavior and overdose, and to improve social functioning.

The medications show clear evidence of effectiveness only when used as long-term treatment, much like insulin for diabetes. There is very little indication of short-term benefit.

These medications also are cost-effective, with costs for maintenance medications to treat opioid addiction roughly comparable to costs for diabetes medications.

Complex, arbitrary restrictions
The reports on state Medicaid and insurance company restrictions were conducted through surveys by The AVISA Group and the Treatment Research Institute. The researchers reported that insurance company managers were reluctant to respond to questions about opioid medication restrictions.

The state Medicaid coverage report showed that while every state covers at least one FDA-approved opioid addiction medication, restrictions vary widely from state to state and often create de facto denial of access. Coverage limits for lifetime benefits and daily dosages are common. Restrictive prior authorizations add another level of obstacles. Information about restrictions and compliance regarding these medications is very difficult to obtain from state agencies. Many states require other treatments to fail first before addiction medications are covered.

Similarly, private insurance companies' restrictions on opioid addiction medications are complex, contradictory and often arbitrary. Insurance companies widely use utilization management techniques like prior authorization that impedes the use of addiction medications, and they also limit coverage on quantities of medication.

Dosage and quantity restrictions on opioid addiction medications by insurance companies and state Medicaid programs contravene recommendations from professional medical associations and the U.S. Substance A
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SOURCE American Society of Addiction Medicine
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