Arkansas Health Plan Panel Recommends Limits on Coverage for Opioids

An Arkansas health panel has recommended limiting coverage of opioid prescriptions in health plans that cover tens of thousands of state employees and teachers.

The recommendations, which are aimed at curbing drug dependence and abuse, were compiled by the State and Public School Life and Health Insurance Board’s Drug Utilization and Evaluation Committee, the Arkansas Democrat-Gazette reported. The suggestions were based on guidelines issued last year by the U.S. Centers for Disease Control and Prevention.

The committee said health insurance plans should cover prescriptions for a maximum dose of 50 morphine milligram equivalents per day for acute and chronic pain. Patients being treated for cancer or a terminal illness wouldn’t be affected by the restrictions, which would apply to patients who aren’t already using opioids.

Dr. Hank Simmons, the committee chairman, said the board may also consider reducing the dosages prescribed for some of those already taking opioids within about six months.

“These changes are going to elicit a lot of strong commentary and probably some good and some bad feeling,” Simmons said.

The health plans cover about 45,000 school employees and 26,000 state employees. The plans spend about $2.6 million a year on opioid prescriptions, which is only about 2 percent of the health plans’ total drug spending, according to Geri Bemberg, assistant director of the Arkansas Evidence-Based Prescription Drug Program at the University of Arkansas for Medical Sciences.

A report by the program shows that 153 health-plan members filled at least 12 prescriptions for opioid medications from July through September 2016.

“We’re not going at this as a cost-saving method,” Bemberg said. “It’s more public health and really trying to get our population healthier and to better treatments for their pain.”