Health insurer Cigna will no longer require preauthorization for the opioid partial agonist buprenorphine in patients with opioid use disorder.
Although the change in policy applies to plans nationwide, the announcement came not long after New York State Attorney General Eric T. Schneiderman requested information from the insurer about its medication-assisted treatment policies as part of an investigation into barriers to treatment.
Dr. Margaret H. Chaplin
“Under our commercial plans, we have agreed to voluntarily remove prior authorization from all medications used in medication-assisted treatment for opioid use disorder. This will help make it easier for our customers to access coverage for the medications they need,” she said.
Medication-assisted treatment (MAT) employs a combination of psychosocial therapies and full or partial opioid agonists such as methadone, naltrexone, or buprenorphine to treat opioid dependency. The Substance Abuse and Mental Health Services Administration and the Centers for Disease Control and Prevention both endorse the use of MAT, as numerous studies have shown it is significantly more effective than either medication or psychosocial support alone.
Because providers of MAT are federally required to specialize in addiction medicine and obtain a license from the Drug Enforcement Agency to prescribe buprenorphine, the new policy will not affect most clinical practices. For those who treat people with opioid use disorder, however, the impact could be powerful.
“I can tell you in my 10 years or so of prescribing buprenorphine, I have never had a preauthorization turned down,” Margaret Chaplin, MD, a psychiatrist and addiction medicine specialist in New Britain, Conn., said in an interview. “It was really just a hoop we had to jump through that seemed designed to discourage treatment more than to insure appropriate treatment.
“At our clinic, we are thrilled to see this barrier coming down,” said Dr. Chaplin, who also serves as director of Community Mental Health Affiliates in New Britain.
Cheers also went up from others who treat this patient population. American Society of Addiction Medicine President-Elect Kelly J. Clark, MD, MBA, said in a statement: “There is often a small window of opportunity for a person seeking help to engage in treatment. Waiting for days to obtain medication to treat this condition represents an unnecessary risk for a deadly outcome. Hopefully, other payers will follow Cigna’s lead.”
Dr. Chaplin did not have any relevant disclosures.
On Twitter @whitneymcknight