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June 15, 2015

New bill would make insurers pay for safer, abuse-deterrent painkillers

Generic drugs can often have addictive effects, but new types of opioid drugs are capable of deterring such abuse. However, because the drugs are expensive, many insurers require patients to pay more for them.

A New Jersey assemblyman has proposed a bill that would require insurance companies to include the abuse-deterrent opioids in their least expensive class of prescriptions, NJ Spotlight reports.

Assemblyman Herb Conaway Jr. said the bill would save lives by lowering the risk of addiction. 

By requiring that all abuse-deterrent drugs be included in the least-expensive tier, the bill would eliminate the incentive for drug makers to negotiate for these higher volumes, [Sarah] Adelman said. While patients would no longer see higher out-of-pocket costs for the abuse-deterrent drugs, there would be higher “back-end” costs priced into monthly insurance premiums as a result, she said. 

Conaway estimated that the bill would cost New Jersey roughly $2 million.

“I think this is one of these situations where you come back and say, ‘What is the cost of someone’s life?'" Conaway told NJ Spotlight.

As a compromise, Sarah Adelman, vice president of the New Jersey Association of Health Plans, suggested that insurers include at least one or two abuse-deterrent opioids in the lowest-priced tier, rather than all of them. 

The bill was passed in the Assembly Health and Senior Services Committee earlier this month in a bipartisan, 9-0 vote. A Senate version of the bill has yet to be introduced.

Read more from NJ Spotlight.