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Insurer Sees Sky-High Incidence of Opioid Use Disorder

Opioid prescriptions and abuse are more common among people covered under BlueCross BlueShield of Tennessee’s employer-sponsored plans than they are nationwide.

In fact, in 2016 BCBST’s commercial insurance members had the highest rate of diagnosed opioid use disorder in the country, according to a report from the Blue Cross Blue Shield Association that looked at national medical claims from 2010 to 2016.

Nationally, 8.3 people were diagnosed with the disorder per 1,000 in that period. In Tennessee, the rate was 16.5.

Alabama was second with 16.4, followed by Kentucky with 15.2.

BCBST’s members had the sixthhighest percentage of people (23.9 percent) who filled at least one opioid prescription in 2015. Alabama, Arkansas, Louisiana, Mississippi and Oklahoma ranked higher.

Nationally, 21.4 percent of people in commercial Blue Cross plans filled an opioid prescription in 2015. People receiving cancer, palliative or hospice treatment were not included in the study.

Tennessee is one of the states hardest hit by opioid abuse and misuse. The overdose death rate has continued to climb even as the state tries to crack down on the number of prescriptions. In 2015, deaths hit a record 1,452.

The new report — America’s Opioid Epidemic and its effect on the nation’s commercially insured population — includes data from employers that selffund insurance plans as well as companies that buy into commercial plans.

The opioid abuse epidemic is a factor in the shortening of life expectancy in the U.S.

In Tennessee, white men are more likely to die from overdose than women or other races.

But the national study found that women over the age of 45 were more likely to be diagnosed with opioid use disorder than men. Under the age of 45 the reverse is true.

The report found that in states such as Tennessee, where opioid abuse was more common, there was a slower growth of treatment for the abuse.

As a way to curb prescriptions BCBST has increased communication with providers about problematic prescribing patterns and implemented more stringent authorizations beforeopioids can be prescribed. Cigna has similar programs in place.

“Opioid abuse and misuse is one of the most pressing public health concerns in our state, and we feel a responsibility to do our part to address this issue,” said Dr. Andrea Willis, chief medical officer of BlueCross BlueShield of Tennessee.

Three dozen Blue Cross insurance companies comprise Blue Cross Blue Shield Association. The study looked at claims from 30 million people in commercially insured plans, which do not include Medicare, Medicaid or individually purchased insurance. Axial Healthcare, a Nashville-based startup, helped with pharmacy consultancy.

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