By favoring opioid medications as the cheaper option whencompared with safer but more expensive alternatives, insurers may havehelped enlarge the opioid crisis.

That’s according to a report by the New York Times and independent journalismorganization ProPublica, which says that the New York Stateattorney general’s office may be taking a closer look at the roleinsurers and pharmacy benefit managers might be playing in thecrisis. Last week the AG’s office sent letters to the three largestpharmacy benefit managers, CVS Caremark, Express Scripts andOptumRx, asking how they were addressing the crisis.

Related: State opioid policies could be decreasinglong-term dispensing

The two news organizations analyzed Medicare prescription drugplans covering 35.7 million people in 2017’s second quarter andfound that just a third of covered individuals “had any access toButrans, a painkilling skin patch that contains a less-riskyopioid, buprenorphine.”

However, it adds that “every drug plan that covered lidocainepatches, which are not addictive but cost more than other genericpain drugs, required that patients get prior approval for them.” Inaddition, nearly all plans covered common opioids, with very fewrequiring prior approval for them to be prescribed. Also, insurershave placed additional barriers between the approval of addictiontreatments than they have in place for the addictive substancesthose treatments are aimed at.

The report cites an example of a woman being treated withButrans whose insurer, UnitedHealthcare, stopped covering the drugin January. Butrans had cost UnitedHealthcare $342 for a four-weeksupply, the report says, while the drug that the patient finallyended up with after an unsuccessful appeal is long-actingmorphine.

Not only did UnitedHealthcare not question the morphineprescription, but its cost to the insurer is just $29 for a month’ssupply.

UnitedHealthcare has said that the patient has not yet exhaustedthe appeal process to receive Butrans and that it “will work withher physician to find the best option for her current healthstatus.”

Dr. Thomas R. Frieden, who led the Centers for Disease Controland Prevention under President Obama, is quoted in the reportsaying that insurance companies, with few exceptions, had “not donewhat they need to do to address” the opioid epidemic. He adds thatat present it’s easier for most patients to get opioids than toreceive treatment for addiction.

The Department of Health and Human Services is also looking atwhether insurance companies make opioids more accessible than otherpain treatments.

Experts studying opioid abuse are also concerned about insurers’limits on addiction treatments. And the analysis of Medicare plansalso found that restrictions are prevalent there as well — eithervia requirements for prior authorization or prohibitiveout-of-pocket costs for the drugs that treat addiction.