Open AccessPrescription Drug Coverage for Treatment of Low Back Pain Among US Medicaid, Medicare Advantage, and Commercial Insurers
Author(s) -
Dora H. Lin,
Christopher M. Jones,
Wilson M. Compton,
James Heyward,
Jan L. Losby,
Irene B. Murimi,
Grant Baldwin,
Jeromie Ballreich,
David A. Thomas,
Mark C. Bicket,
Linda Porter,
Jonothan C. Tierce,
G. Caleb Alexander
Publication year - 2018
Publication title -
jama network open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.278
H-Index - 39
ISSN - 2574-3805
DOI - 10.1001/jamanetworkopen.2018.0235
Subject(s) - medicine , medicaid , interquartile range , medicare advantage , formulary , medical prescription , pharmacy , medicare part d , prescription drug , emergency medicine , health plan , family medicine , health care , pharmacology , economics , economic growth
Key Points Question Among US insurers, what are the coverage policies for pharmacologic treatments for low back pain? Findings In this cross-sectional study of 62 products used to treat low back pain examined across 50 Medicaid, Medicare Advantage, and commercial insurance plans, utilization management strategies were common for nonopioids and opioids alike. Key informant interviews with plan executives underscored the frequent absence of comprehensive strategies to improve chronic pain treatment and to better integrate pharmacologic and nonpharmacologic opioid alternatives. Meaning Our findings underscore important opportunities among insurers to redesign coverage policies to improve pain management and reduce opioid-related injuries and deaths.
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