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Insurer steps up in Pa.'s fight against opioid crisis

Insurance companies, part of the health care industry, don’t often resort to military analogies to tout their initiatives. But Highmark Inc.’s announcement last week declaring a “war on opioids” seems apt.

The company rolled out two new promising programs to enhance its other ongoing efforts to help drive down the opioid addiction crisis that has claimed so many lives in northwestern Pennsylvania and nationwide.

First, Highmark has expanded to this region a pilot program launched in West Virginia in 2016. As the Pittsburgh Post-Gazette has reported, Highmark, together with a company called axialHealthcare, analyzed claims data to help identify prescription trends. Based on that analysis, more than 250 West Virginia medical providers received targeted guidance on opioid prescription best practices and pain management.

The initiative led to a 28 percent reduction in patients receiving opioid prescriptions from multiple doctors. And importantly, the number of patients receiving prescriptions for both sedatives and opioids — which can heighten the risk of overdose — dropped by more than 25 percent.

In introducing the program to Pennsylvania, Highmark also added a new tool that will allow doctors to assess in real time a patient’s risk of abusing opioids.

As a second measure, Highmark said it will introduce in March prescription limits for certain members who are prescribed opioids for the first time. The policy is based on Centers for Disease Control and Prevention data that shows that a person who uses opioids for one day has a 6 percent chance of becoming addicted, while those who use them for more than a week face a 13 percent chance of becoming addicted. Exceptions are built in for those in need of opioids for severe pain that cannot be addressed through other means.

No single strategy will end the opioid epidemic. But the problem began decades ago in doctors’ offices as physicians — acting on drug company assurances that opioids were not addictive — ramped up prescriptions. Any measures to uproot the problem must include efforts to force those prescription rates down and stem the flow of opioids into our communities.

Highmark’s new policies dovetail well with recent state reforms, including the Prescription Drug Monitoring Program. It is also good business sense. As Highmark indicated Thursday, one in 250 of its commercial members were addicted to opioids in 2017. The problem cost members $93 million nationwide.

At last count, 124 people died of drug overdoses Erie County in 2017. Statewide, 4,642 died of overdoses in 2016 and the number is expected to rise when 2017 statistics are compiled. Problems spurred by addiction cut across all sectors from health care to criminal justice and must be addressed on each front in order to save lives.

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