BATON ROUGE, La. – Opioid drugs still have a stronghold on many Louisianians as they try to treat pain. But Blue Cross and Blue Shield of Louisiana is beginning to see a loosening of opioids’ grip on its members. Blue Cross claims data show prescriptions written and opioid pills, tablets or capsules dispensed have decreased by almost 20 percent in the first full year of the policy, and these numbers are hovering near 30 percent since 2016.
“We revised our opioid coverage policy with two specific goals in mind: to decrease the quantity of opioids in the community and to minimize the number of patients who become chronic opioid users,” says Milam Ford, pharmacist and Blue Cross vice president of pharmacy services. “I’m pleased to say we are meeting these goals while still meeting the needs of our members.”
Three-year Look Back: Using 2016’s full year of data as a baseline, Blue Cross began tracking the effects of its work to educate prescribers and patients about its plans to revise coverage policies. Blue Cross claims data from Jan. 1, 2016, to Jan. 1, 2019, show nearly 28 percent fewer opioid prescriptions and 33 percent fewer opioid quantities dispensed in Louisiana communities.
First Full Year: Blue Cross launched its new opioid policy Jan. 1, 2018. Blue Cross claims data from Jan. 1, 2018, to Jan. 1, 2019, show nearly 13 percent fewer opioid prescriptions per 1,000 members and 18.3 percent fewer opioid quantities dispensed per member, per month.
All data is based on Blue Cross’ commercial members who have pharmacy benefits administered by Blue Cross and its pharmacy benefit manager and does not include Medicare or Medicaid claims.
Policy Overview: Under the Blue Cross opioid coverage policy, members may have a limit on how many days’ supply of an opioid drug they can fill at a time covered under their plans, or doctors may need to ask for prior authorization before an opioid drug may be covered. Blue Cross makes exceptions for members who are already on long-term pain medications and meet certain criteria, who have cancer or who are receiving end-of-life comfort care. To set appropriate coverage guidelines, Blue Cross developed its policy after considering a breadth of clinical guidelines, industry best practices, state regulatory requirements, and its own member population.
“The national opioid epidemic is a particularly acute health threat in our state, and Blue Cross is committed to helping our members – and all Louisianians – avoid the devastating effects of opioid misuse and overuse,” says Deirdre Barfield, M.D., Blue Cross senior medical director.
“Our policy is intended to protect our members and support physicians and pharmacists in helping our shared customers treat pain safely,” adds Ford.
Help for Substance Use Disorders: Blue Cross and Blue Shield of Louisiana customers who want information about drug or alcohol treatment for themselves or family members covered on their plans can call the 24/7 Substance Use Member Hotline at 1-877-326-2458 to speak with a clinical professional. The hotline is operated by New Directions, an independent vendor that provides behavioral health services for Blue Cross and its subsidiaries.
Get Rid of Leftover Drugs Safely: Blue Cross and Blue Shield of Louisiana, the Office of the Louisiana Attorney General, National Association of Drug Diversion Investigators and Louisiana law enforcement offices have provided drug drop boxes for safe drug disposal across the state. The boxes are a secure, anonymous way for people to get rid of unused, expired or leftover prescription medication, which can prevent it from being stolen or misused. Anyone can take leftover prescription drugs to any of the drop boxes for safe disposal. To find sites to drop off leftover or unwanted drugs, go to www.bcbsla.com/safedrugdrop. Blue Cross will also sponsor Drug Take Back Day to be held next month.
For information about safer pain care, Blue Cross members may go to www.bcbsla.com/pharmacy.
About Blue Cross and Blue Shield of Louisiana
Blue Cross and Blue Shield of Louisiana is committed to our mission to improve the health and lives of Louisianians. We invest both time and money in the communities we serve, supporting the health and wellbeing of Louisianians through more than 200 charitable organizations.
With our subsidiaries, HMO Louisiana and Southern National Life, we provide group and individual health insurance plans, life and disability insurance, group voluntary products and administrative services to one out of four Louisiana residents. Blue Cross and Blue Shield of Louisiana also provides Medicare supplement and Medicare Advantage plans and is a partner in offering the Healthy Blue Medicaid Managed care plan. Louisiana is the only state where we operate, with offices in every major region to serve our customers.
Founded in New Orleans in 1934, Blue Cross and Blue Shield of Louisiana is a tax-paying non-profit health insurer. We are a private mutual company, owned by our policyholders, with an independent Louisiana Board of Directors and no shareholders. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association.
To learn more, visit our website at www.bcbsla.com.