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Opioids Given to Almost 1 in 4 Medicaid Patients, Study Finds

  • Almost 30% of users took the addictive drugs for over a month
  • Express Scripts study examined 3.1 million people in 14 states

Nearly one in four people on Medicaid, the U.S. health program for the poor, received powerful and addictive opioid pain medicines in 2015, according to research by a drug-benefits management firm.

The analysis by Express Scripts Holding Co., one of the largest managers of Medicaid plans’ drug benefits for the past two decades, found that about 6 percent of all prescriptions in the program were for the pain pills. The report shows the extent to which the controversial class of narcotic pain medicines has penetrated the U.S.’s health-care safety net.

The report analyzed 1.8 million opioid prescriptions written for 3.1 million Express Scripts Medicaid members across 14 states in 2015 at a total cost of $90.1 million. Medicaid, which is jointly administered by the states and the federal government, covers more than 50 million Americans, according to the Kaiser Family Foundation.

Concern about opioids has increased in recent years amid a surge in addiction and overdose deaths. Several state attorneys general are investigating whether drugmakers illegally marketed the medications. More than 20 states, counties and cities have sued opioid makers and suppliers in the past year. U.S. regulators took the unprecedented step of asking Endo International Plc to pull its drug Opana ER off the market because of risks related to abuse. 

Drug overdoses are the leading cause of accidental death in the U.S., with prescription opioids responsible for 20,101 deaths in the U.S. in 2015, according to the American Society of Addiction Medicine.

Among Express Scripts Medicaid members prescribed the pain pills, 28.5 percent received more than a month’s worth of the drugs. Among children age 19 and under, 4.3 percent were on the drugs, according to the analysis.

While brand-name medications accounted for less than 10 percent of the prescriptions, they were responsible for 45 percent of the cost, according to the report.

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