Blue Cross Blue Shield Association Study Shows More Than One in Five Members Fill an Opioid Prescription Annually

Subtitle
The 65 percent rate of increase in the use of medication-assisted treatments lags behind the 493 percent rate of increase in opioid use disorder diagnoses from 2010 through 2016

CHICAGO – Twenty-one percent of Blue Cross and Blue Shield (BCBS) commercially insured members filled at least one opioid prescription in 2015, according to a new study by the Blue Cross Blue Shield Association (BCBSA). Data also show BCBS members with an opioid use disorder diagnosis spiked 493 percent over a seven-year study period.

The report, “America’s Opioid Epidemic and Its Effect on the Nation’s Commercially Insured Population,” represents a comprehensive study of medical claims from BCBS members using opioid painkillers, as well as those diagnosed with opioid use disorder over a seven-year period.*

The study also finds that:

  • The 65 percent rate of increase in the use of medication-assisted treatments lags behind the 493 percent rate of increase in opioid use disorder diagnoses from 2010 through 2016. States that have experienced the greatest growth in the use of medication-assisted treatments are not necessarily the areas most impacted by opioid use disorders. High rates of treatment relative to opioid use disorder occur in New England and lower rates occur in the South and parts of the Midwest.
  • Among those 45 and older, women have a higher rate of opioid use disorder than do men. Among people younger than 45, men have higher rates of opioid use disorder than women. Women fill more opioid prescriptions than males across all age groups.
  • Long-duration prescription opioid use and opioid use disorder overlap by region, with the highest rates in the South and the Appalachian Region.
  • Patients who fill high-dosage opioid prescriptions have much higher rates of opioid use disorder than patients with low-dose prescriptions across both short- and long-duration regimens.

“Opioid use disorder is a complex issue, and there is no single approach to solving it,” said Dr. Trent Haywood, senior vice president and chief medical officer for BCBSA. “It will take a collaborative effort among medical professionals, insurers, employers, communities and all levels of government working together to develop solutions that effectively meet community needs.”

“Blue Cross and Blue Shield companies around the country recognize their responsibility to respond and do their part to address this terrible crisis,” said Kim Holland, vice president of state affairs for BCBSA. “BCBS companies are already undertaking initiatives to help families and communities address opioid use disorder by forging partnerships with the medical community to promote best practices in prescribing and providing critical education to the public to raise awareness of the risks of opioid use. With more than 106 million members and deep ties to every community in America, we are uniquely positioned to help find solutions to this serious problem.”

Last year BCBSA created the Mental Health and Substance Use Disorder Workgroup comprising BCBS companies’ top medical, pharmacological, behavioral health, fraud, public health and policy experts to develop recommendations on how to work with others in the health care community to ensure patients who need pain medication are safely getting the right medication, at the right time. The committee recently endorsed the Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain.

The BCBS Health Index identifies substance use disorder as the fifth most impactful condition in affecting the health of commercially insured members in the U.S. For more information about BCBS companies’ local efforts to combat opioid misuse, visit https://bcbs.com/about-us/capabilities-initiatives/addressing-americas-opioid-addiction.

This is the thirteenth study of the Blue Cross Blue Shield: The Health of America Report® series, a collaboration between BCBSA and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and insights into health care affordability and access to care.

For more information, visit www.bcbs.com/healthofamerica.

*Members diagnosed with cancer or who were undergoing palliative or hospice care were excluded from this analysis.

About Blue Health Intelligence
Blue Health Intelligence (BHI) is the nation’s premier resource for data-driven insights about healthcare trends and best practices, promoting healthier lives and more affordable access to safe and effective care. BHI leverages a team of analytics experts and advanced technology, coupled with access to the greatest number of healthcare claims—172 million lives—gathered over 10 years in a safe, HIPAA-compliant, secure database. The resulting conformed, reliable data set has the broadest, deepest pool of integrated medical and pharmacy claims, reflecting medical utilization in every ZIP code. Blue Health Intelligence (BHI) is an Independent Licensee of the Blue Cross Blue Shield Association. BHI is a trade name of Health Intelligence Company, LLC. www.bluehealthintelligence.com.

About Blue Cross Blue Shield Association

Blue Cross Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for one in three Americans. For more information on the Blue Cross Blue Shield Association and its member companies, please visit BCBS.com. We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out the BCBS Blog for up-to-date information about BCBSA.

The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies.