BlueCross to Stop Covering Oxycontin in Tennessee in 2019

 In Health Plans, Pharmacy

The largest health insurance company in Tennessee, BlueCross BlueShield, will stop covering OxyContin prescriptions as of January 1, 2019. OxyContin is the brand name of the opioid oxycodone, a highly addictive pain reliever manufactured by Purdue Pharma and one of the primary drugs contributing to the opioid overdose epidemic, which last year killed 1,268 people in Tennessee and 49,000 nationwide.

As an alternative, BlueCross is encouraging doctors to prescribe two other painkillers that are engineered to be more difficult to abuse, Xtampza and Morphabond.

“We are not telling our physicians you cannot prescribe this. We are not telling our members you cannot receive this,” said Natalie Tate, BlueCross vice president of pharmacy. “We are just drawing a line that we will not continue to pay for this and we have alternatives we have now put into place.”

A spokesperson for Purdue Pharma, Robert Josephson, said the decision by BlueCross didn’t make sense because the drug was reformulated to deter abuse in 2010. The Food and Drug Administration now lists Xtampza, Morphabond and OxyContin as abuse deterrent drugs.

The new policies will impact most customers who are insured with BlueCross through their employer. The changes will also affect Tennesseans who are insured by BlueCross through the Affordable Care Act. Some of the company’s largest customers—employee groups with what is called “self-funded” insurance—will be able to opt out of the coverage changes. Cancer and hospice patients will also be exempt from the coverage changes but their prescriptions will still require approval from BlueCross.

BlueCross is not the first large insurer to move away from covering OxyContin. Cigna also stopped covering OxyContin this year, as did Florida Blue, the largest insurer in Florida. Both companies replaced OxyContin with Xtampza, saying they were trying to minimize their role in the opioid epidemic.

To read more, click here for the full article in the Tennessean.

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