Prescription abuse prevention saves money and lives


News about deadly pain pills makes me think about what payers can do to help tackle the public health problem of prescription drug abuse. 

"America is in pain--and being killed by its painkillers," notes an article in the current issue of Consumer Reports. Opiate prescriptions rose 300 percent in the past ten years, as Vicodin and other drugs containing its active ingredient became the most often-prescribed medications in the country, the article noted.

Almost 17,000 Americans every year--46 people a day--die from pharmaceutical drug overdoses, a death rate that's climbed more than 400 percent since 1999, the article added.

Opioid abuse has driven up hospital emergency department visits, as FierceHealthcare recently reported. And new addiction risks may follow the Food and Drug Administration's controversial approval of Zohydro, since long-acting painkillers are prone to theft and abuse, Consumer Reports noted. It's grim news.

The problem of prescription drug abuse highlights threats special investigators fight: Healthcare fraud, resulting from forged prescriptions and drug diversion; healthcare abuse, stemming from overutilization of drug benefits for non-medical reasons (think of pill mills and doctor shopping); and wasteful healthcare spending, since drug abuse and its costs may be preventable.  

Insurers foot medical bills not just for addicted subscribers, but for covered spouses, partners or dependents who may need health services after exposure to a loved one's addiction. The problem has wide ripples.

After learning that more than 30,000 of its members received more than a 30-day supply of opioids in 2010, Blue Cross Blue Shield of Massachusetts implemented a precertification program to manage benefit payment for these drugs. Results were promising: The insurer reduced prescriptions for opioids such as Percocet by 20 percent and halved the prescription volume for longer-lasting painkillers

Another meaningful action payers can take is participating in a national prescription drug take-back day coordinated by the U.S. Drug Enforcement Administration (DEA).  

The program's goal is "to provide a safe, secure and environmentally-responsible means of disposing of prescription drugs while also educating the general public about the potential for abuse and trafficking of medications," according to the agency.

On take-back days, people visit designated collection sites to discard extra or expired substances. Law enforcement agents arrange for secure disposal of the drugs without taking names, asking questions or contaminating the environment.     

Many Americans stockpile pills. At an Illinois collection site, for example, one woman dropped off nearly 50 years' worth of medications. Seven take-back days in four years removed 390 tons of pills from circulation through 6,072 collection sites, the DEA reported.

Ridding homes of superfluous drugs is important, since "keeping opioids around is like keeping a loaded gun in your medicine cabinet," Richard Blondell, M.D., told Consumer Reports. More than half of those who abuse prescription painkillers first received them through friends or relatives, the DEA noted. And every day, an average of 2,500 teens use prescription drugs recreationally for the first time.  

Supporting a prescription drug take-back event is a way for insurers to serve the public health and safety of their communities. Events like this align with wellness programming focused on primary prevention. Prescription drug take-back events can also support payers' anti-fraud goals.

The DEA makes participation inexpensive and easy through an online partnership toolbox with customizable press releases, posters and other materials.

Supporters of the take-back initiative include Kaiser Permanente, the Partnership for a Drug-Free America, the International Association of Chiefs of Police, the National Association of Attorneys General, the National Association of Boards of Pharmacy, the Federation of State Medical Boards and the National District Attorneys Association.    

The next national take-back day is planned for September 27 at sites that will be listed the DEA's website on September 1. Insurers interested in participating should contact and coordinate with law enforcement at a nearby collection site, the DEA told FierceHealthPayer:Anti-Fraud.

Fighting prescription drug abuse requires the attention of many stakeholders. But prevention is worth our best efforts, since it saves not only healthcare dollars but the beauty and potential of human lives. - Jane (@HealthPayer)

Related Articles: 
Forging prescriptions is easy, criminal says
States tackle spiraling drug costs
Doctor shopping: What to look for, how to prevent it
BCBS requires pre-approval to curb painkiller abuse
EDs see dramatic increase in visits related to opioid use
States wrestle with prescription data to curb abuse
Convicted pain doc says patients duped him
Overprescribing doc charged with murder