Florida Blue To End Coverage For OxyContin

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Florida Blue To End Coverage For OxyContin

Florida Blue recently announced that beginning January 1, 2018, the insurance company will no longer cover OxyContin in favor of Xtampza ER, an extended-release oxycodone drug that is more difficult to abuse. The new policy applies to all Florida Blue individual and group plans, but not Medicare Advantage.

The company states that Xtampza is better suited to guard against crushing, snorting, and injecting – common methods that abusers use to invoke a faster (and possibly more lethal) high.

The new policy will not, however, apply to generic oxycodone, which according to Scott McClelland, vice president of commercial and specialty pharmacy, is less privy to abuse as it is sold as immediate-release and at lower doses.

Xtampza ER is made by Collegium Pharmaceutical Inc., but its abuse-deterrent technology does not ensure that the drug cannot be abused. The company states that the drug is designed to make tampering harder, but that abuse of Xtampza ER is still possible.

According to Florida Blue, the company pays for around 1.5 million opioid prescriptions each year, and 8% of that is for prescriptions that last beyond 30 days. Those who take opioids beyond a month are at a heightened risk for dependency and overdose.

The company already has quantity limitations on both short- and long-acting painkillers, and also requires prior approval of extended-release opioid drug prescriptions, such as the fentanyl patch.

The company states that these policies are in place to prevent abuse and addiction, which is ravaging throughout Florida and across the U.S. According to state data, fentanyl, morphine, and heroin are the top causes of opioid overdose deaths in Florida, and oxycodone is fourth.

In October, Cigna also announced it would discontinue coverage of OxyContin use for employer-based health plans in favor of an alternative, as part of an initiative to reduce opioid prescriptions by 25%.

~ G. Nathalee Serrels, M.A., Psychology



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