Advanced Protection for First-time Opioid Users

Oct 24, 2018
Express Scripts supports bipartisan legislation to improve opioid prevention and treatment. Our Advanced Opioid Solution shifts first-time opioid users to safer, short-term prescriptions.
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As President Trump prepares to sign new bipartisan legislation today aimed at addressing the opioid crisis, we are proud to release new data showing a dramatic shift in first-time opioid users enrolled in our Advanced Opioid ManagementSM solution being prescribed safer, short-term prescriptions of 7 days or less. Short-term opioid prescriptions can significantly reduce the risk of a patient misusing or abusing a medication. The new opioid law supports our ongoing efforts by strengthening our ability to work collaboratively with patients, prescribers, pharmacies, and plan sponsors to help stop opioid abuse and misuse.

New solutions are needed more than ever, given the outsized toll this epidemic is taking on Americans:

  • Only 3% of opioids are prescribed by pain specialists
  • Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids
  • $53 billion in annual economic burden costs
  • 2 million Americans are addicted to prescription narcotics

In just one year, Express Scripts’ Advanced Opioid Management solution has seen enrolled clients achieve notable results that align with recommendations put forth earlier by the U.S. Centers for Disease Control & Prevention:

  • 93% of patients prescribed an opioid for the first time started with a 7-day supply or less;
  • 77% of patients prescribed a long-acting opioid as initial therapy were redirected to a safer, short-acting medication; and
  • The average days’ supply per claim for first time opioid users dropped 55%, from 18.6 days prior to enrollment to 8.3 days.

Overall, clients that adopted our utilization management criteria saw an average of 94.8% of opioids prescriptions covered for 7 days or less after one year. In addition, these clients also experienced a 73.2% average decrease in the number of prescriptions for more than a 7-day supply.  These two data points support why Express Scripts’ Advanced Opioid Management solution is the leading program among all large PBMs serving 20 million or more patients.

The root causes of opioid abuse and misuse are complex, but we know that engaging patients, prescribers, and pharmacies at critical touchpoints can mitigate the potential for abuse, and we’re proud of the results of our Advanced Opioid Management solution. We applaud Congress and the Administration for acting decisively to require electronic prescribing of controlled substances and the development of new electronic prior authorization standards.

Recently, we expanded our point-of-sale strategy to closely monitor three commonly abused medications that, when combined with opioids, increase the risk of dangerous side effects and overdose.  This work complements the SUPPORT for Patients and Communities Act (HR 6), which was approved with overwhelming bipartisan support and signed into law by President Trump.  The SUPPORT for Patients and Communities Act is a critical step forward in helping to eliminate the scourge of opioid abuse, particularly for Medicare and Medicaid beneficiaries.

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