Pubdate: Fri, 06 Jan 2017
Source: Tennessean, The (Nashville, TN)
Copyright: 2017 The Tennessean
Contact: http://www.tennessean.com/SITES/OPINION/submit-editor.shtml
Website: http://www.tennessean.com/
Details: http://www.mapinc.org/media/447
Author: Dr. Andrea D. Willis (chief medical officer at BlueCross
BlueShield of Tennessee.)

REDUCING RISKS OF ADDICTION ONE PRESCRIPTION AT A TIME

"Prevention is preferable to cure." These words are part of the modern
Hippocratic Oath, which guide my work and the work of my fellow physicians
across our state. Today we are facing a crisis that demands a preventive
solution: prescription painkiller abuse.

The stakes are real -- I've heard too many heart-wrenching tales of lives
lost and families torn apart. We know many of these addicts never intended
to be drug abusers, but began with a real need to treat pain from injuries
or other medical conditions.

And the vast majority of prescribers are doing what is in the best
interest of their patients to effectively manage pain. Yet despite good
intentions and their best efforts, opioid prescriptions and addiction have
escalated in the last decade, along with drug overdose deaths.

At BlueCross BlueShield of Tennessee, we covered one million opioid
prescriptions for our members in 2015. That scale has given us deep
insights on usage patterns that uniquely position us to help prevent
painkiller abuse before it starts.

We launched a public health initiative in 2016 guided by an external panel
of clinicians with pain management expertise. Our first goal is to educate
prescribers on best practices for opioid use. Another is to change
prescribing patterns and place quantity controls to reduce the harmful
effects these drugs have on some members.

We began our phased approach this year with modest quantity limits and
prior authorization (PA) requirements for new long-acting opioid
prescriptions. The PA will ensure that providers are discussing a
treatment plan and medication history with their patients before writing a
prescription for chronic pain management.

Our intent was to phase in changes without throwing anyone into crisis. To
date, we've been successful with only minor disruptions. It is also
important to note we are granting immediate exceptions for members
undergoing oncology and end-of-life care.

On Jan. 1, we implemented the next round of prescription pain medication
changes based on CDC guidelines and provider feedback. These include a PA
on all long-acting opioid prescriptions (new or current) for all members
with BlueCross pharmacy benefits.

We also set new quantity limits on both long and short-acting opioids.

Finally, we've put in place morphine equivalent dose limits across all
pain medication prescriptions. This will provide an objective standard and
help manage the cumulative impact of the various opioid drugs a member may
be prescribed.

The aim of our efforts is not to deny care or generate cost savings. Our
only goal is to reduce the devastating effect that opioids -- when
overprescribed or not used as intended -- have had on Tennessee families
and communities.

We know these changes may be met with concern and resistance by some
parties. But no one else in our state should have to suffer from
painkiller addiction. No mother should have to be told her child has
overdosed, and no child should have to be separated from their home as a
result of a parent's addiction.

The responsible steps we're taking to prevent misuse and abuse are simply
the right thing to do.

Dr. Andrea D. Willis is chief medical officer at BlueCross BlueShield of
Tennessee.
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