Insurer Refuses to Cover Purdue Pharma’s Oxycodone

Blue Cross Blue Shield of Tennessee, the largest insurer in the state, has announced that it will no longer cover prescriptions for Purdue Pharma’s pain reliever oxycodone. The insurer’s decision to drop coverage follows that of Cigna and Blue Cross Blue Shield of Florida, which began denying coverage for the drug in 2017 in response to the ongoing opioid crisis.

While Purdue Pharma’s oxycodone, branded as Oxycontin, was reformulated in 2010 to make it more difficult to abuse, critics say that its widespread use has contributed to the ongoing epidemic of opioid addiction. The drug manufacturer is facing dozens of lawsuits over its aggressive push to market oxycodone for a wide range of pain relief indications.

Blue Cross Blue Shield of Tennessee will instead cover long-lasting, abuse-deterrent opioids. “We felt it was time to move to those products and remove Oxycontin from the formulary, which does still continue to have a higher street value,” said Natalie Tate, PharmD, the company’s vice president of pharmacy. The company also will begin to cover alternative pain therapies.

Insurance companies are not alone in acting on opioid addiction. Legislators across the country are taking steps to reduce access to the drugs and limit the circumstances in which they can be prescribed. Earlier this year, Tennessee passed laws restricting doctors’ discretion and punishing doctors who overprescribe addictive pain medications.

Sources: Nashville Public Radio, June 8, 2016; NPR, September 12, 2018.