The purpose of this group is to continue the work of the previous groups and focus on collecting and disseminating guidelines for managed care pharmacists regarding integrated care models and benefit designs that effectively address substance use disorder.
More than 30% of Medicare beneficiaries and 40% of patients dually eligible for Medicare and Medicaid use opioids. With an estimated 8%-12% of patients developing an opioid use disorder (OUD) after initiating opioids, opioid misuse is a significant public health challenge, especially among high-risk Medicare populations. Medication-assisted treatment (MAT) is the use of medications for the treatment of OUD and to prevent relapse to opioid use. MAT is the most effective treatment for OUD. There are a variety of barriers to MAT therapy that may delay access to treatment.
Where We Stand: Managed care pharmacists have a responsibility to work with patients and other health care professionals to ensure the appropriate use of opioids and to ensure that prescriptions are dispensed and utilized for legitimate medical needs.
An analysis published in JMCP found that patients in the North Carolina Medicaid program continued to receive opioids and benzodiazepines concurrently despite known risks. Read the results and recommendations that may benefit this and other Medicaid populations.
Recognizing the widespread and devastating nature of the opioid crisis, AMCP formed the Addiction Treatment Advisory Group in 2015 based on the recommendation from the AMCP Partnership Forum, Breaking the Link between Pain Management and Opioid Use Disorder.