Opiods and drugs for lower back pain?  John’s Hopkins conducted a study recently that looked into the policies of Medicare, Medicaid and commercial insurers.  The Abstract is listed below.

“Importance  Despite unprecedented injuries and deaths from prescription opioids, little is known regarding medication coverage policies for the treatment of chronic noncancer pain among US insurers.

Objective  To assess medication coverage policies for 62 products used to treat low back pain.

Design, Setting, and Participants  A cross-sectional study of health plan documents from 15 Medicaid, 15 Medicare Advantage, and 20 commercial health plans in 2017 from 16 US states representing more than half the US population and 20 interviews with more than 43 senior medical and pharmacy health plan executives from representative plans. Data analysis was conducted from April 2017 to January 2018.

Main Outcomes and Measures  Formulary coverage, utilization management, and patient out-of-pocket costs.

Results  Of the 62 products examined, 30 were prescription opioids and 32 were nonopioid analgesics, including 10 nonsteroidal anti-inflammatory drugs, 10 antidepressants, 6 muscle relaxants, 4 anticonvulsants, and 2 topical analgesics.

Conclusions and Relevance  Given the effect of coverage policies on drug utilization and health outcomes, these findings provide an important opportunity to evaluate how formulary placement, utilization management, copayments, and integration of nonpharmacologic treatments can be optimized to improve pain care while reducing opioid-related injuries and deaths.”

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