CATCH-22 … FDA & DEA mandates… Part D won’t pay for ?

Report: Medicare Part D plans less apt to cover opioids with abuse deterrents

https://drugstorenewsce.com/editorial-news-item/3/6090

Despite high-profile efforts to implement abuse-deterrent labels and properties on brand-name opioids, advisory company Avalere Health’s latest research notes a key blind spot in the efforts — accessibility. In particular, the research shows that Medicare Part D plans cover generic opioids that lack abuse-deterrent features at a higher rate than it covers branded opioids. 
 
“While there has been significant attention on the development and approval of new abuse-deterrent drug products, there has been noticeably less consideration of access to such products,” Avalere CEO Dan Mendelson said.
 
Particularly with regard to oxycodone hydrochloride, the brand-name OxyContin received approval from the Food and Drug Administration in 2013 for abuse-deterrent labeling, but since 2012, Part D plan coverage for it has dropped from 61% to 46%. On the other hand, every Part D plan covers generic oxycodone hydrochloride. As a result, seniors have less access to safer opioids.
 
“While prescription opioid abuse continues to be a priority for public health experts and lawmakers, coverage for these products by Part D plans is limited and plans are increasingly favoring lower-cost generic products on their formularies,” Avalere SVP Caroline Pearson said. “Policymakers seeking to limit opioid abuse will have to balance the desire for greater access to abuse-deterrent opioids with the increased costs of such medications to public programs and private payers.”

2 Responses

  1. This will leave me wanting the less expensive medication, since I am on Medicare, and my Pain Managements doctor wanting to prescribe the abuse deterrent med. because of the regulations under which he must operate. Why not let doctors make the choice of which medication is right for this particular patient?

    • Gail, is your Pain Doctor certified to prescribe Suboxone and or Bupinoprine? The reason I ask? I was referred to a Dr. who was “certified” to prescribe Suboxone, when I specifically, as did my family doctors office, asked if they did CHRONIC pain and was simply trying to find a closer physician closer to home. He walked in, wrote a script for Suboxone and sent me home. I took only a QUARTER of that tablet and I felt like I was starving for air. Wound up in the ER. FUNNY Part, he I’d AGAINST OPIOD PAIN MEDS AND HE IS THE First doctor who OVERPRESCRIBED MEDS to all of his patients, including myself, abou8 years ago. Sorry for the long post but you have a RIGHT to refuse his treatment. I requested a referral that day and got one.

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