In Effort To Help Stem Opioid Overdose Crisis, Florida Blue To Stop Covering OxyContin in January

Florida Blue wants to do its part to help stem the opioid crisis; a notable exception to what has been a lackluster response to the problem on the part of the insurance industry. When FDA chief Scott Gottlieb issued a call this summer for PBMs and insurers to help solve the opioid crisis, it was mostly ignored. The FDA has no regulatory powers over either industry. A meeting took place September 6, in which only one company participated—CVS.

As the Miami Herald reports, instead of OxyContin, Florida Blue will cover another opioid called Xtampza ER, which can’t be crushed for injection or snorting. That makes the street value of Xtampza ER much less than for OxyContin.

“Most physicians, most plans have had a hands-off approach for a number of years, and we see where we are now,” Scott McClelland, the insurer’s vice president of commercial and specialty pharmacy, tells the newspaper. “We think it’s time for more people, including physicians in our community, the nurses, even the families to take a more proactive approach in trying to manage this epidemic.”

It’s worth it.

Miami Herald: “Opioids were the direct cause of death of 2,538 Floridians and contributed to an additional 1,358 deaths in 2015, the last year data is available.”



Does the move go far enough? Gottlieb told Bloomberg in the summer that he thinks insurers and PBMs can help by changing instructions on drug labels, or perhaps requiring doctors to educate patients about the risks of taking prescriptions for longer periods of time.

“There shouldn’t be 30-day prescriptions for a tooth extraction, or 30-day prescriptions for a hernia repair,” Gottlieb told Bloomberg.

Gottlieb also wants to experiment with making sure that prescribing conforms more to clinical guidelines. “They’re not in there right now,” Gottlieb said. “There’s no information in the drug label about what the appropriate dispensing should be.”

Better adherence to guidelines could possibly make prescribing less burdensome, he added. 

Source: Miami Herald