BCBS of Alabama launching new opioid management strategy


In an effort to combat the growing opioid abuse epidemic in Alabama and as a measure of concern for their customers’ care and safety Blue Cross and Blue Shield of Alabama is launching a new opioid management strategy.

In 2015, 5.8 million prescriptions for opioid medications were given to Alabamians, making it the highest prescribing state in the nation for prescription opioid drugs.

According to Blue Cross and Blue Shield Association’s Health of America report on the opioid epidemic:

  • 26 percent of Blue Cross and Blue Shield of Alabama’s commercially insured members filled at least one opioid prescription in 2015, compared to 21 percent nationally
  • 6.5 percent of our members were on a long-duration opioid regimen in 2015, compared to 3.8 percent nationally
  • 16.4 per 1,000 members were diagnosed with opioid use disorder in Alabama in 2016, double that of 8.3 nationally
  • 29 percent of our members with opioid use disorder received medication-assisted therapy in 2016, compared to 37 percent nationally

In recent years, Alabama has seen many deaths due to prescription drug overdoses. The use of opioid pain relievers lead to 723 drug-related deaths in 2014, and 5,128 deaths from 2006 through 2014.

Therefore, Blue Cross and Blue Shield of Alabama feels that it is necessary to implement the following requirements:

  • Extended-release opioids will require a prior authorization for all initial fills of long-acting opioid medications. Members currently receiving these drugs will not be impacted.
  • Immediate-release opioids will not require prior authorization but will have quantity limits. The first prescription fill will be limited to a seven-day initial supply. After an initial seven day supply is filled, additional prescriptions may be obtained without pre-authorization. Members currently receiving these drugs will not be impacted.
  • Naloxone, the antidote for an opioid overdose, will be available to Blue Cross members for a generic copay. These include the forms of prefilled syringes and nasal spray. Evzio, the branded auto-injector, will no longer be covered due to egregious pricing.

The conditions will go into effect Feb. 1, 2018.