Government Watchdog Warning Grandmas About Opioid Overuse

Kelly Brantley says her grandmother’s doctor offers to write her a prescription for opioids when something hurts. Grandma’s pharmacist son has to put his foot down and nix the script, she said.

So Brantley, a Washington health-care consultant, told me she wasn’t surprised by a federal study released at the end of June. It showed that in 2017, nearly one in three Medicare beneficiaries received at least one prescription opioid through the Medicare Part D drug benefit.

Not everyone has a pharmacist son to step in to stop that, Brantley said.

The study was by a government watchdog, the Department of Health and Human Services’ Office of Inspector General. They’re the folks who are charged with combating waste, fraud, and abuse in the HHS’s 300 programs, including Medicare.

“I don’t mean to blame doctors, but there’s been a trend over the past decade or two that pain management mean opioids,” Brantley told me when I asked her about the study. People have come to expect full pain relief and that can lead to a system where too many are taking opioids, she said.

The opioid crisis has been declared a public health emergency.  In 2016, more than 42,000 opioid-related overdose deaths occurred in the U.S.—115 per day. That’s twice the number of opioid-related overdose deaths that occurred just six years before, the OIG said.

There are concerns about fraud, abuse, misuse, and diversion of opioids obtained under Medicare Part D. That’s why the OIG was involved.

The study wasn’t without some positive news.

In 2017, about 458,000 beneficiaries received high levels of opioids for at least three months. That's down 8 percent from 2016.

Part D spending for opioids dropped significantly in 2017—from $4 billion to $3.4 billion; although part of that was pegged to a drop in opioid prices.

Despite that, the statistics in the report are still troubling, Ceci Connolly, president and CEO of the Alliance of Community Health Plans, which represents about two dozen health plans, told me.

She said she puts her hope on legislation passed by the House at the end of June that would enhance access to medication-assisted treatment, a combination of medicine and counseling and behavioral therapy for substance abuse disorders.

Read my article here.

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