Report: Medicare Part D plans less apt to cover opioids with abuse deterrents

Despite high-profile efforts to implement abuse-deterrent labels and properties on brand-name opioids, advisory company Avalere Health’s latest research notes a key blind spot in the efforts — accessibility. In particular, the research shows that Medicare Part D plans cover generic opioids that lack abuse-deterrent features at a higher rate than it covers branded opioids. 

 

“While there has been significant attention on the development and approval of new abuse-deterrent drug products, there has been noticeably less consideration of access to such products,” Avalere CEO Dan Mendelson said.

 

Particularly with regard to oxycodone hydrochloride, the brand-name OxyContin received approval from the Food and Drug Administration in 2013 for abuse-deterrent labeling, but since 2012, Part D plan coverage for it has dropped from 61% to 46%. On the other hand, every Part D plan covers generic oxycodone hydrochloride. As a result, seniors have less access to safer opioids.

 

“While prescription opioid abuse continues to be a priority for public health experts and lawmakers, coverage for these products by Part D plans is limited and plans are increasingly favoring lower-cost generic products on their formularies,” Avalere SVP Caroline Pearson said. “Policymakers seeking to limit opioid abuse will have to balance the desire for greater access to abuse-deterrent opioids with the increased costs of such medications to public programs and private payers.”