Insurance Companies and the Opioid Epidemic

Home / Drugs / Insurance Companies and the Opioid Epidemic


Insurance Companies and the Opioid Epidemic

Insurance and the Opioid Epidemic


Insurance companies are at a critical point right now. Do they continue their long-time practices, or assist in the weakening of the opioid epidemic? At the moment, insurance companies are part of the trinity sustaining the epidemic; pharmaceutical companies, private and public insurers, and medicine prescribers. All three play an exclusive role in the opioid epidemic, concurrently they are all in unique positions to help fight the endemic. Insurance companies in particular are taking steps towards improvement. Insurers have a distinct interest in the opioid epidemic, as they are the ones paying for it. Literally.

Prescription Costs

The biggest complaint patients have with insurance companies are the prices and availability of non-addictive pain medication. Pain medications such as morphine and oxycodone with extremely high susceptibility are significantly less expensive than non-habit forming medications like Butran patches and Vivitrol. While insurance providers without opposition often approve opioids, patients commonly have to undergo vigorous processes to obtain less addictive medicines. Time is sensitive when it comes to those with substance dependencies. If they have to file numerous appeals, they will lose enthusiasm and go back to their poor habits.

Who’s Committed?

In November 2018, sixteen insurance companies signed a commitment to begin to tackle the opioid epidemic. Together those sixteen companies are responsible for the healthcare of 248 million Americans. Aetna, AmeriHealth, Anthem, BlueCross/ Blue Shield, Cigna, and United and 10 additional insurance providers will all abide by eight principles listed in the agreement. All involved insurance providers pledge to perform personal diagnosis, create individualized treatment plans, discuss and encourage long-term outpatient programs; increase access to FDA approved medication, and several other important points.

Additionally, insurers are being encouraged to cut back on prescription payments. While they can never block a pharmacist from filling a subscription, insurance companies can refuse to pay for any prescription. This power would be conducted in situations where someone who has been flagged for doctor shopping has managed to receive another subscription. 3 million opioid subscribers obtain subscriptions from five or more doctors. Insurers and doctors are both being prompted to take a deeper look into a patient’s medical history before writing or financing a prescription filling.

Future Plans

Cigna has announced its goal of reducing the number of opioid overdoses by 25% by December 2021. The insurance giant plans to accomplish that objective with several strong notions. First, the company will use innovative analytic technology to predict those who are at risk of addiction and intervene as necessary. Second, Cigna will ask all care partners to sign an agreement pledging to join and do their part in condensing the opioid epidemic. Partners are being asked to begin treating addiction as a chronic condition. Finally, Cigna will notify medical professionals when suspicious prescription patterns arise.

Who’s joining?

In the private sector, CVS is leading its industry in utilizing its resources to perform its part in eliminating the surge of opioid addiction. The pharmacy giant has installed two-thousand opioid drop-off boxes outside various store locations and police stations throughout the country. To further reduce the amount of unused pills floating in society, CVS has begun limiting first time opioid subscriptions to only 7-10 fulfillment periods with no required pre-authorization.

CVS has stated while they want to defeat addiction, if the situation does arise, the company wants to be source of information for treatment options. CVS pharmacists will soon begin giving lectures to schools and other community outlets. The lectures will target parents and equip them with the knowledge and tools to spot and treat signs of addiction. Finally, CVS has stocked all 9,000+ retail locations with the life-saving overdose reversal drug Narcan.

Do you suspect that your loved one is abusing drugs or alcohol? At Seabrook ®, we work with you to construct the intervention with your loved one in a supportive, empathic way for all involved. Our highly qualified and certified family interventionists can help you deal with your unique situation. To learn more, call today: 800-761-7575.