A newly released report from Express Scripts outlines the significance of the current opioid epidemic, their impact on Medicaid, and prevention strategies for reducing misuse.
“Opioids use affects people of all ages and across all socioeconomic backgrounds,” Express Scripts wrote in the report. “However, Medicaid members are 10 times more likely to suffer from addiction and substance abuse than the general population. As one of the largest providers of PBM services to managed Medicaid plans, Express Scripts analyzed the annual opioid use of 3.1 million Medicaid members.”
The report, “A Nation in Pain: Focus on Medicaid,” analyzed factors impacting opioid use across 14 states in 2015. The authors outlined current factors motivating the need for more research into opioid abuse, including the fact that drug overdose is now the leading cause of death in the United States. Meanwhile, pharmacies across the country dispense 69 tons of oxycodone and 42 tons of hydrocodone a year, with more than 650,000 opioid prescriptions dispensed every day.
Weight Loss Surgery Patients at High-Risk for Long-Term Opioid Use
What Opioid Leads to Long-Term Use?
The researchers found that Medicaid members are disproportionately affected by the opioid crisis, with more than 25% of members having filled and opioid prescription in the last 30 days. Additionally, the researchers found that one-third of Medicaid member have taken an opioid within the last 30 days. The report also noted that among these opioid users, 4.3% of them are children younger than 19 years.
Among the other findings in the report, the researchers highlighted that opioid make up 6% of Medicaid prescriptions and 4.1% of plan costs.
“When thinking of how to combat the opioid epidemic, solutions can take a number of forms,” Express Scripts wrote. “One solution is to look at utilization patterns of opioid users—both prescriber and pharmacy utilization as patients abusing opioids tend to seek out multiple prescribers and pharmacies. In fact, more than a quarter of Medicaid members received the same pain medicine from more than one prescriber.”
The researchers found that, on average, 8.9% of opioid-using Medicaid members used four or more pharmacies to fill their prescriptions.
The report also called for expanded use of abuse-deterrent formulations. However, the researchers noted that high costs associated with these formulations are hindering uptake among Medicaid members.
“While intriguing, these new abuse-deterrent medications are primarily brand drugs and are extremely expensive compared to generics forms,” the researchers wrote. “Due to their high costs, Medicaid plans typically promote acute and long-acting generic opiates as first line treatment for narcotic pain management, demonstrated by generics accounting for 90.6% of pain medication claims included in the study.”