Designed to prevent users from overdosing, abuse-deterrent opioids aim to diminish the effects of today’s epidemic by limiting the ways addicts can alter prescription painkillers for their needs. These drugs, subject for approval by the United States Food and Drug Administration (FDA), aren’t as accessible to patients as some may think — especially seniors.

New research from Avalere Health, an advisory company specializing in healthcare business strategy and public policy, found that Medicare Part D plan coverage rates for OxyContin, a prescription painkiller with abuse-deterrent properties, decreased by 28% from 2012 to 2015. Coverage for all prescription opioids decreased by 10% during the same period.

Caroline Pearson, senior vice president of Avalere Health, said in an interview that her community’s research didn’t look into why abuse-deterrent opioids are less likely to be covered by Medicare. “However, it is reasonable to assume that plans are electing to cover lower-cost opioids, including generics, instead of newer products with properties intended to reduce abuse,” she said.

The same study revealed that Oxycodone Hydrochloride (HCl) immediate release (IR), a generic opioid without abuse-deterrent properties, is covered by all Part D plans in 2015. “Thus far, plans do not seem inclined to cover abuse-deterrent drugs on the merits of their anti-abuse properties. As such, we would need to see a change of Medicare policy to further encourage or require plans to prioritize abuse-deterrence over cost,” Pearson said.

There were 16,235 deaths involving prescription opioids in 2013, an increase of 1% from 2012, the Centers for Disease Control and Prevention (CDC) unveiled this year. Some abusers attempt to crush or dissolve painkillers to snort, smoke or inject the drugs for an intensified high. “However, the most common form of abuse remains taking a higher-than-recommended dose of oral opioids,” she said. “No abuse-deterrent product can prevent taking too many pills at once.”

To curb opioid abuse, the majority of states in the country have implemented a prescription drug monitoring program (PDMP). Missouri, still the only state without one, seems to making progress in its legislature. Other have said continuing education for physicians prescribing opioids is a necessity. President Obama’s drug control priorities for the upcoming fiscal year include reducing prescription drug and heroin abuse by allocating additional funding to states with PDMPs, expanding and improving treatment for addicts, and spearheading efforts to make naloxone more readily available to first responders.

Medicare Part D plans can also be modified to prevent the opioid epidemic from growing. “Since Part D plans have discretion about which products to cover, policymakers would need to institute additional rules to mandate that plans cover abuse-deterrent products,” Pearson said. “Alternatively, plans may be more likely to expand coverage for these drugs if they have additional evidence about the utilization and long term cost and quality benefits of these savings.”

“This study will raise awareness of the issue of abuse-deterrent opioids and their limited Part D coverage,” she said. “Policymakers can use this data to better inform the public debate about access to these products.”

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Source: Forbes