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New CDC Study Affirms Blue Cross Blue Shield Of Massachusetts'
Impact On Opioid Crisis

CONTACT:  Ian Meropol
(617) 246-2367

Insurer's pain medication safety program is working to reduce opioid prescriptions by 15 percent

BOSTON — October 20, 2016 —A new study released today by the Centers for Disease Control and Prevention (CDC) confirms that Blue Cross Blue Shield of Massachusetts' Prescription Pain Medication Safety Program is reducing the number of opioid-based prescriptions among its members. The CDC research found:

  • The average monthly prescription rate of opioids, like OxyContin®, dropped by 15 percent
  • There were 14,000 fewer prescriptions for these drugs written per month
  • A six to nine percent decrease in members using prescription opioids

As the CDC study reports, overdose deaths involving opioid pain medications are epidemic in the United States, in part because of high opioid–prescribing rates and associated abuse of these drugs.

"After Blue Cross implemented a new opioid utilization program, there was a significant decrease in both the number of opioid prescriptions among its members as well as a reduction in the percentage of members with a prescription for opioid-based medications," said Dr. Macarena Garcia, lead author of the CDC study. "The implication is that evidence-based utilization management practices can promote best practices in opioid prescribing, while reducing the risk of misuse of these medications."

Blue Cross' own analysis of its program has shown that over three years it has:

  • Eliminated an estimated 21.5 million doses of opioid-based medications in the community
  • Reduced claims for long-acting opioids such as OxyContin by approximately 50 percent by switching patients to short-acting pain treatments
  • Stopped 62,000 members from receiving inappropriate levels of acetaminophen

"Our program has become a model for the state and nation, and this new CDC report, which looks at our data in new ways, shows it can ensure people in pain get the treatment they need, while reducing the risk of substance use disorder," said Tony Dodek, Blue Cross Blue Shield of Massachusetts Associate Chief Medical Officer.


Blue Cross' Prescription Pain Medication Safety Program was implemented in July 2012 to help reduce the rise in people addicted to pain medications. Developed in partnership with doctors, pharmacists, and pain management and addiction experts, the program requires:

  • A treatment plan between doctor and patient that considers non-narcotic options
  • A risk assessment for addiction signed by the patient
  • An opioid agreement between the patient and prescriber outlining expected behavior of both parties
  • The identification of a single pharmacy or pharmacy chain to be used for all opioid prescriptions, when indicated
  • A prior authorization requirement for all new short-acting opioid prescriptions for more than 30 days (two 15-day fills) and for all new long-acting opioid prescriptions

About Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Massachusetts ( is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We‘re the trusted health plan for more than 30,000 Massachusetts employers and are committed to working with others in a spirit of shared responsibility to make quality health care affordable. Consistent with our corporate promise to always put our 2.8 million members first, we‘re rated among the nation's best health plans for member satisfaction and quality. Connect with us on Facebook, Twitter, YouTube, and LinkedIn.


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