Independence Blue Cross, the area's largest private health insurer, is tightening restrictions on its members' access to OxyContin and its generic version, commonly prescribed pain relievers that experts say have contributed to the national opioid epidemic.
"Combating the opioid epidemic is a top priority at Independence Blue Cross," said Richard Snyder, chief medical officer at Independence. "We want our members to have access to the most cost-effective pain medication, while at the same time helping to reduce the risk of these drugs being abused."
Beginning Oct. 1, the extended-release oxycodone medications will be removed from some plans' formularies and others will require prior authorization for the opioids before prescriptions can be filled. This means patients will still be able to purchase the medications — but they will cost more.
Instead, Independence will push members toward a newer brand, Xtampza XR, made by Collegium Pharmaceutical, which the insurer described as an "abuse-deterrent form of oxycodone" because it is harder to crush, grind, cut, and inject.
Any patients newly prescribed OxyContin, made by Purdue Pharma, or a generic version of it will first need to try Xtampza. Patients who already take OxyContin or generic will also need to try Xtampza when current prescriptions run out. After trying Xtampza, they and their doctors can seek authorization from Independence to switch back to OxyContin if necessary.
The move builds on efforts by the insurer to reduce opioid prescribing.