Oct. 26, 201 8 – AAS – State health officials Friday recommended adding several drugs that treat opiate addiction to the Medicaid preferred drug list, which could give addicts more treatment options, something doctors and lawmakers say is direly needed amid Texas’ growing opioid crisis.
The Texas Health and Human Services Commission’s Drug Utilization Review Board recommended adding Bunavail, Zubsolv and Vivitrol to the preferred drug list, which means they would be available as first-line options for people on Medicaid struggling with substance abuse problems.
Texas in 2016 saw a 7.4 percent increase in opioid overdoses. Experts have testified that those increases actually might be much higher due to inadequate reporting. Law enforcement professionals and drug treatment advocates pleaded with lawmakers this summer to expand access to treatment for struggling addicts. They have said that resources in Texas are lacking, particularly medication-assisted treatment options like methadone and buprenorphine.
Bunavail and Zubsolv are narcotic combination drugs that include buprenorphine and naloxone and help control opioid withdrawal symptoms. Vivitrol is a nonnarcotic option that blocks opioid receptors in the brain and prevents people from get ting high off opioids. A new nonnarcotic drug called Lucemyra that treats opioid dependence was not recommended for the preferred drug list. The recommendations still must be approved by the state’s health commissioner, who will review them in the coming months.
Currently, the Medicaid formulary includes only a single buprenorphine product to treat opiate addiction, Suboxone, tablets that help with withdrawal. Many other options require prior authorization and for patients to try other drugs first before they can be approved, which addiction specialist Thomas Kosten said can slow down the treatment and recovery process.
“The medical impact of delays on patient treatment for opioid dependence can be insidious,” Kosten, who is a professor at the Baylor College of Medicine, wrote in a letter to the review board ahead of Friday’s vote. “Accessible treatment must be a core policy goal and is essential in this disease where the window for treating patients is narrow and often driven by a sudden seminal event such as an arrest, accident, or overdose. If individuals ready to seek treatment are not immediately engaged, they will revert to their addictive behaviors that drive the continued use of drugs, thereby further hurting themselves and our communities.”
Kosten said adding more options to the preferred drug list will allow the state to negotiate lower prices and better serve Medicaid patients.
Carl Hunter, a recovering addict representing the nonprofit Recovery People program, spoke to the board Friday, urging it to allow open access to all medications that treat opioid addiction. “People’s lives are at stake,” Hunter said. “Texans receiving Medicaid should not be subjected to restrictive policies that limit their access to care.”
Several Texas lawmakers have also made similar recommendations.
“As with any epidemic, a core component to addressing a health crisis is to ensure that prescribers have easy availability to all medical interventions necessary to effectively treat their patients,” state Rep. J.D. Sheffield, R-Gatesville, who sits on the House Select Committee on Opioids and Substance Abuse Committee, wrote in a letter to the board. “Failure to provide open access to the best match to the right medication as determined by the patient and their prescriber runs a significant risk of relapse and serious health issues.”
Sheffield said the select committee is exploring ways to reduce barriers for people trying to obtain drugs that treat opioid dependence. The committee is making a list of recommendations that will help Texas tackle substance abuse problems ahead of the legislative session that starts in January.
“It is time that Texas Medicaid move into the vanguard of treatment of this epidemic and demonstrate leadership for all the payers in Texas by advancing commonsense policies where broad consensus exists,” Sheffield wrote to the board.
The 20-member Drug Utilization Review Board, made up of doctors and pharmacists, meets quarterly to consider new drugs to include on the Medicaid preferred drug list. It reviews different classes of drugs at each meeting, meaning it may not add other opiate dependence treatment medications to the formulary until next year.
