Health insurer spending on treatment for painkiller dependence is on the rise, and proving to be one of several tools needed to curb the epidemic of opioid addiction.
Between 2011 and 2013, insurer spending on buprenorphine -- a narcotic used to treat opioid dependence -- rose by 38 percent per member per month, according to a study of 12 health plans covering 12 million Americans by the pharmacy benefits manager Prime Therapeutics.
Buprenorphine in combination with a similar drug, naloxone, increased by 124 percent in overall per member per month spending, Prime noted.
Prime researchers found more than 5,000 members in the 12 health plans with one or more buprenorphine treatment claims between January 2012 and December 2013, with nine months as the average length of therapy.
Among the commercial members for one Blue Cross and Blue Shield insurer in the South, buprenorphine and buprenorphine-naloxone combination therapies accounted for 74,000 claims between 2012-2013 -- with 87 percent of those paid out to the tune of almost $22 million.
Nationally, opioid abuse remains a huge problem for insurers, in terms of spending on medically dubious painkiller prescriptions that can lead to addiction and fraud.
Individuals at high risk of opioid abuse can have total healthcare costs three times higher than average, Prime researchers estimated, including prescriptions, hospitalizations, outpatient consultations, behavioral counseling and rounds of relapse.
But dependence therapy can be beneficial as an addiction treatment and also help avoid high-cost spending.
In a study between 2010 and 2013, Aetna found that buprenorphine treatment was correlated with a 35 percent decrease in inpatient admissions and a 40 percent decrease in overall healthcare costs, from $18,050 to $13,033 per member. Opioid abstinence among those members increased from 49 percent to 85 percent over the course of three years.
The best way to curb the painkiller abuse epidemic, though, is to prevent individuals from becoming addicted in the first place, which has prompted insurers and providers to reconsider the appropriateness of opioid-based painkillers.
Insurers looking to boost their efforts at addiction prevention may find some new evidence from the American Association of Neurology to guide coverage decisions.
For non-cancer chronic pain related to conditions like tension headaches, fibromyalgia and lower back pain, "there is no substantial evidence for maintenance of pain relief or improved function over long periods of time without incurring serious risk of overdose, dependence, or addiction," the American Association of Neurology argues in a new position paper.