There's an apparent crisis in opioid prescription drug overdoses, and private and public insurers are footing most of the bill for the drugs that are causing the deaths.
That's what a study cited in Health Affairs found. Researchers compared payments for opioid-based prescription drugs from 1999 to 2012, and saw an alarming trend in patient out-of-pocket payments.
Where most plan members' OOP payments have been increasing in general, opioid patient OOP costs fell during the period from an average of $4.40 per 100 morphine milligram prescription in 2001 to $.90 in 2012.
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The researchers, working on behalf of the Centers for Disease Control and Prevention, pretty much blamed the 2006 Medicare D plan creation for the shift.
"Since the implementation of Medicare Part D in 2006, Medicare has been the largest payer for opioid pain relievers, covering about 20–30 percent of the cost," the researchers said in the abstract of the study. "Medicare spends considerably more on these drugs for enrollees younger than age sixty-five than it does for any other age group or than Medicaid or private insurance does for any age group."
One possible conclusion from the study: The fact that insurers pay the bulk of the cost of opioid prescriptions may well be contributing to the increasing use of those drugs since 1999. The researchers recommended further studies to determine whether insurers should alter their payer strategies to see if it led to fewer overdoses.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
