Independence Blue Cross to place additional restrictions on OxyContin® and Oxycodone ER to help reduce opioid use and abuse

Independence Blue Cross (Independence) announced that as part of its commitment to helping reduce opioid misuse and overprescribing, it is placing new restrictions on OxyContin® and Oxycodone ER. These products will be removed from some formularies and will require a new prior authorization on others, effective October 1.

In addition, Xtampza® XR, an extended-release abuse-deterrent form of oxycodone, will become a preferred brand drug, also effective on October 1. Xtampza® is designed to make crushing, grinding, cutting, chewing, and injecting the drug more difficult.

All members on OxyContin and Oxycodone ER will require a trial of Xtampza ER. Those members who already have an authorization and are receiving OxyContin and Oxycodone ER will not require prior authorization to be switched to Xtampza.

“Combatting the opioid epidemic is a top priority at Independence Blue Cross,” said Dr. 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.”

Independence’s changes align with the most up-to-date prescription and formulary management policies regarding opioids from the Centers for Disease Control and Prevention (CDC) which include:

  • Opioids should not be considered a first-line option or routine therapy for chronic pain;
  • Opioid dosage should be limited to less than 90 morphine milligram equivalent (MME) per day when possible;
  • Opioid therapy should not be initiated with extended-release/long-acting opioids as they are associated with higher overdose risks.

Independence members will be able to purchase OxyContin and Oxycodone ER with a prior authorization from their doctor. However, as a non-preferred drug, these prescriptions will have higher cost shares.

Independence recently released results that highlight its success in reducing opioid use and prescriptions.

“Since 2014, our efforts to educate members and providers, and restrict avoidable use of opioids to situations that warrant, has resulted in a 45 percent reduction in opioid users (45,000 fewer members), a 35 percent reduction in opioid prescriptions (100,000 total), and an 18 percent reduction in the morphine equivalent dose,” said Eric Estes, senior director Pharmacy Services at Independence.

In addition, since limited first-time low-dose opioid prescriptions to a five-day supply, the number of members using opioids dropped 22 percent during the last six months of 2017 compared to the same time period in 2016.

Visit Independence our read what the Independence Blue Cross Foundation is doing to fight opioid abuse.

Visit Independence for substance abuse, and learn about what the Independence Blue Cross Foundation is doing to fight opioid abuse.


About Independence Blue Cross
Independence Blue Cross is the leading health insurance organization in southeastern Pennsylvania. With our affiliates, we serve 8.5 million people in 28 states and the District of Columbia, including 2.5 million in the region. For almost 80 years, we have been enhancing the health and well-being of the people and communities we serve by delivering innovative and competitively priced health care products and services; pioneering new ways to reward doctors, hospitals, and other health care professionals for coordinated, quality care; and supporting programs and events that promote wellness. To learn more, visit Connect with us on  Facebook and on Twitter. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube and follow us on Twitter.

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