BCBS Alabama to No Longer Cover OxyContin Beginning in 2019

BIRMINGHAM, AL – Effective Jan. 1, 2019, Blue Cross Blue Shield of Alabama will no longer cover OxyContin for members with the exception of Blue Advantage members. This is in response to concerns for members’ care and safety.

Since 2015, opioid prescriptions in the U.S. and in Alabama have declined. Over the last two years, opioid prescriptions for BCBS Alabama’s commercial members have decreased 18 percent. While progress is being made, this issue calls for continued action by all parties.

Beginning Jan. 1, 2019, the following changes to Blue Cross’ Opioid Management Strategy for commercial members will be implemented:

• Roxybond, the new instant release oxycodone formulation that is considered “abuse deterrent” by the FDA, will be covered.
• Lucemyra (lofexidine), the first non-opioid approved drug to treat the symptoms of opioid withdrawal, will be covered.
• OxyContin, and its generic (oxycodone ER), will no longer be covered. Xtampza ER (oxycodone ER) will be available to all members at a non-preferred brand cost share.

Letters have been mailed to members receiving OxyContin or oxycodone ER notifying them of the change and recommending that they follow up with their doctor to discuss potential alternatives. Providers have also been notified with a list of covered alternatives.

Several alternatives will be covered at the lowest copay for members who need a long-acting opioid for around the clock pain management: Morphine ER, Tramadol ER, Fentanyl ER and Methadone will be covered.

Blue Cross always encourages its members to consult their doctors about any treatments or prescription drugs they may need, and the company relies on physicians’ expertise to know what is best for their patients. Blue Cross will continue to develop and adopt actionable policies and procedures that promote safe prescribing of opioid medication and appropriate access to treatment for opioid use disorder. In addition, we will continue to collaborate with Alabama physicians and pharmacists to help curb the growing epidemic of opioid misuse by offering support, resources, and educational tools to network providers. This, combined with our strategies to improve access to medications used to treat substance abuse and drug overdoses, demonstrate our commitment to the health of our membership.