ST. PAUL, Minn., Sept. 28, 2016 /PRNewswire/ -- Prime Therapeutics LLC (Prime), a pharmacy benefit manager serving over 22 million members nationally, analyzed pharmacy claims for both short and long-acting opioids, including an evaluation of long acting opioids with and without abuse-deterrent properties. The research found that claims for short acting opioids decreased while long acting opioid claims increased resulting in an overall slight (3.9 percent) decrease in opioid claims from 2014 to 2015. All findings will be presented at the Academy of Managed Care Pharmacy (AMCP) Nexus event Oct. 3-6 in National Harbor, Md.
Prime studied administrative pharmacy claims from 15 million commercially insured members from Jan. 1, 2014 through March 31, 2016. In this time period, there were 20.5 million opioid claims. For this analysis, opioids were grouped into four categories: non-abuse-deterrent short acting, non-abuse-deterrent long acting, abuse-deterrent with Food and Drug Administration (FDA) validation, and abuse-deterrent without FDA validation. The FDA has validated seven long acting opioids and approved abuse-deterrent study information in their labels. An additional six products have data suggesting they may have abuse-deterrent properties, but they have not been validated by the FDA to include abuse-deterrent study data in their label.
The annual change in opioid claims from 2014 to 2015 by category showed:
Short acting opioids decreased 4.5 percent
Long acting opioids without abuse-deterrent properties increased 2.0 percent
Long acting abuse-deterrent opioids with FDA validated increased 3.2 percent
Long acting abuse-deterrent opioids without FDA validation increased 26.0 percent
Long acting opioids accounted for 8.0 percent of all claims volume and 48.6 percent of total cost. Short acting opioids represented 92.0 percent of claims and 51.4 percent of cost.
"With new laws requiring coverage of abuse-deterrent opioids, future utilization and cost trends in this category could increase," said Cathy Starner, PharmD, principal health outcomes researcher at Prime. "It is important for insurers to understand both legislation and current utilization patterns to help forecast trend in this drug category."
In addition to cost and utilization, future research should focus on the relationship between abuse-deterrent opioids and decreased opioid overdoses and death. Opioids with abuse-deterrent properties are not proven to completely eliminate abuse. The role of abuse-deterrent opioids in curbing the opioid epidemic is unclear as opioid dependence and overdose still occurs with abuse-deterrent products.
About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and delivers medicine to members, offering clinical services for people with complex medical conditions. Headquartered in St. Paul, Minn., Prime serves just over 22 million people. It is collectively owned by 14 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans.
For more information, visit www.primetherapeutics.com or follow @Prime_PBM on Twitter.
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Last updated on: 29/09/2016
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