Purdue Pharma, the company that makes the opioid painkiller OxyContin, is increasingly under fire for its role in the opioid crisis.  More than half of the 33,000 opioid-related deaths in 2015 were attributed to prescription opioids such as OxyContin. There are currently dozens of lawsuits in progress, accusing Purdue of downplaying the addictiveness of the drug, hiding evidence that they knew of its dangers, aggressively marketing it to both doctors and the public, and offering financial incentives to doctors who prescribed it. Now, in addition to the poor press and the financial burden of the lawsuits, Purdue is facing another setback. Insurance companies are increasingly refusing to pay for OxyContin.

Last October, the insurer Cigna said it would no longer cover OxyContin for customers who are insured through an employer. At the same time, the company announced that it would continue paying for other opioid painkillers, with OxyContin being the only one removed from its preferred drug list. It will continue to provide coverage for people in hospice care or receiving cancer treatments. Cigna has stated its intent to reduce opioid use among its customers by 25 percent by 2019.

Around that same time last year, Florida’s largest health insurance company, Florida Blue, also announced that it would stop covering OxyContin. Instead, it decided to cover a similar opioid called Xtampza ER, which is also made from oxycodone but cannot be crushed, meaning people can’t inject or snort it.  Florida Blue ended coverage of OxyContin for all group and individual health insurance plans, except Medicare Advantage plans (Medicare health plans that are offered by a private company that contracts with Medicare). The company also requires prior authorization for all oxycodone prescriptions for more than seven days, in an effort to keep unused drugs from ending up on the streets. According to one executive, that policy, which has been in place since 2015, led to a 20 percent reduction in the use of long-term opioids by Florida Blue members over 12 months.

Now, the largest insurer in Tennessee has announced that it will join the ranks of insurance companies refusing to cover OxyContin. Blue Cross Blue Shield of Tennessee, which insures 3.4 million Tennesseans, is also moving toward abuse-deterrent opioids like Xtampza. They’re also going to start covering a drug called Morphabond, which is an extended release morphine formulation meant for around the clock pain relief.

INSURANCE COMPANIES REFUSE TO COVER OXYCONTIN

Purdue Pharma insists that no opioid is completely free of abuse potential and that Blue Cross Blue Shield has financial motives for the coverage change. It is true that even abuse-deterrent drugs can still be abused. Even if they can’t be crushed, someone who wants to misuse them can simply take more pills, although the effect won’t be as quick.

If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started.