10 Strategies to Combat the Rx Abuse Epidemic – An Insurer’s Perspective

health insuranceTo address the opioid epidemic, a number of strategies have been developed at both the national and state levels in consultation with medical professionals, law enforcement, insurance companies, and public health and drug prevention experts. In October 2013, the Trust For America’s Health (TFAH) issued a report titled, “Prescription Drug Abuse: Strategies to Stop the Epidemic” identifying ten strategies being employed at the State level. In this article Property Casualty 360 provides a recap of the strategies and shares their thoughts on some insurance company considerations.

The 10 strategies include:

  • Prescription Drug Monitoring Program: Does the state have an operational Prescription Drug Monitoring Program (PDMP)?
  • Mandatory Use of PDMP: Does the State require mandatory use of PDMPs by providers? (i.e., any form of a mandatory use requirement).
  • Doctor Shopping Law: Does the state have a doctor shopping statute?
  • Support for Substance Abuse Services: Has the state expanded Medicaid under the Affordable Care Act, thereby expanding coverage of substance abuse treatment?
  • Prescriber Education Requirement: Does the state require or recommend education for prescribers of pain medications?
  • Good Samaritan Law: Does the state have a law in place to provide a degree of immunity from criminal charges or mitigation of sentencing for an individual seeking help for themselves or others experiencing an overdose?
  • Support for Narcan Use: Does the state have a law in place to expand access to, and use of, Narcan (a/k/a, Naloxone) for overdosing individuals given by lay administrators?
  • Physical Exam Requirement: Does the State require a healthcare provider to either conduct a physical exam of the patient, a screening for signs of substance abuse or have a bona fide patient-physician relationship that includes a physician examination, prior to prescribing prescription medications?
  • ID Requirement: Does the State have a law requiring or permitting a pharmacist to ask for identification prior to dispensing a controlled substance?
  • Pharmacy Lock-In Program:  Does the State’s Medicaid plan have a pharmacy lock-in program that requires individuals suspected of misusing controlled substances to use a single prescriber and pharmacy?


 Source: PropertyCasualty360.com – December 2, 2013