Blue Cross Blue Shield eliminates OxyContin from insurance coverage

Blue Cross Blue Shield, the nonprofit health insurance company, headquartered in Alabama, recently announced that it will be excluding the formulation of OxyContin from its list of covered medication due to changes in the opioid policy.

The insurer has made changes in its policies relating to opioids previously in March 2018 which included such drugs as Percocet, Vicodin and Lortab. The changes in the Blue Cross Opioid Management Strategy are scheduled to take effect from 1st January 2019. The changes will not entirely eliminate OxyContin from coverage but would rather shift the coverage to variants of the drug that are less likely to be abused.

According to the Blue Cross policy, the generic version oxycodone ER and OxyContin itself will not be covered by the insurer. Abusers are known to crush OxyContin which is an extended-release painkiller, to maximize the effect of the drug on their systems and do it faster. Xtampza ER, which also has the formulation of oxycodone ER, however, cannot be crushed to extract the same effect. As Xtampza ER thwarts the approach taken by abusers, it will remain within the insurance cover.

A study found that Xtampza ER could maintain its extended-release properties even after crushing which makes it better than commercially available opioid formulations and even those that are designed to deter opioid abuse. Therefore, Xtampza ER is likely to be less appealing to abusers and also be safer for patients who change dosage to facilitate swallowing.

The insurer has been quoted to say that Roxybond, a new instant release formulation for OxyContin will also be considered for coverage as it has been deemed to be abuse deterrent by the FDA.

Lucemyra, a drug that is arguably the first of its kind to be approved as a drug to treat opioid withdrawal symptoms will also be covered by Blue Cross. In May 2018, FDA approved Lucemyra for short term use while not limiting other possibilities for the drug.