Blue Cross and Blue Shield advocates ibuprofen or aceteminophen for primary pain treatment instead of opioids - Entrepreneur Generations

The Blue Cross and Blue Shield Association now recommends using acetaminophen or ibuprofen instead of opioids as the first or second choice for managing pain. Opioids may be best for things like cancer treatment or palliative care, but "in most cases, ibuprofen and acetaminophen can treat pain more effectively than opioids, said Dr. Trent Haywood, chief medical officer for BCBSA, which has about 106 million members. It's important that physicians understand that alternatives like medication-assisted treatment exist, which pairs medication with behavioral counseling, he said," Alex Kacik reports for Modern Healthcare. According to an internal analysis, 21 percent of BCBS's commercially insured members filled at least one opioid prescription in 2015, and the number of BCBS members with an opioid use disorder diagnoses increased 493 percent from 2010 to 2016.

Opioids are half as effective as over-the-counter pain meds, but two to four times more harmful, according to Haywood. But doctors may not be aware of that, partly because of misleading marketing campaigns by pharmaceutical companies. In 2007 Purdue Pharma, which produces OxyContin, reached a $635 million settlement with the federal government over claims that Purdue downplayed the addictive nature of the drug. Several states and tribes have filed similar claims.

Another reason doctors prescribe opioids so much is that they--and hospitals--used to get performance incentives based on how much pain their patients reported being in. And a recent CNN/Harvard University data analysis found that doctors who prescribe more opioids get financial incentives from pharmaceutical companies in the form of speaking or consulting fees.

Insurers, pharmacies, distributors and providers have restricted the number and size of opioid prescriptions they give out, "but physicians worry that reducing the supply could cut off access to patients who need the potent drugs. Also, insurers have been slow to cover alternatives to opioids. Prior authorization for medication-assisted treatment is another big roadblock," Kacik reports.

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