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Prime Therapeutics finds increase in long-acting opioid claims


ST. PAUL, Minn. — Pharmacy benefit manager Prime Therapeutics recently analyzed pharmacy claims for short- and long-acting opioids, finding a decrease in short-acting opioid claims and an increase in long-acting opioid claims. The review of 15 million commercially insured members found an overall 3.9% decrease in opioid claims from 2014 to 2015. 


Prime said there were 20.5 million opioid claims in the time period between Jan. 1, 2014 and March 31, 2016. During this time, claims for long-acting opioids with FDA-validated abuse-deterrent properties increased 3.2%, while claims on non-validated abuse-deterrent long-acting opioids increased 26%. Short-acting opioids claims decreased 4.5%. Claims on long-acting opioids made up 8% of all claims volume and 48.6% of total cost, and short-acting opioids made up 92% of claims.


“With new laws requiring coverage of abuse-deterrent opioids, future utilization and cost trends in this category could increase,” Prime principal health outcomes researcher Cathy Starner said. “It is important for insurers to understand both legislation and current utilization patterns to help forecast trend in this drug category.”


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