#PBM
Pharmacy Benefit Managers have undoubtedly created barriers 4 patients w #ChronicPain #intractablepain #PalliativeCare #RareDiseases w medical necessity for #opioid analgesics. Citing CDC GLs & going even further. This ex shows 67% decrease in Rxs.
benecardpbf.com/PBF/resources/…
All PBMs do something of this nature & plans vary. They should look for & prevent abuse & fraud, but as outlined in their own literature on policy, Benecard is absolutely interfering btw Drs & patients by using CDC GLs & unilateral decisions on what is appropriate for a patient.
Per CDC, based on their clarification of intent of #opioid guidelines; these policies meet definition of misapplication & misinterpretation. Being as @CDCgov @CDCInjury neglects to intervene in official capacity; PBMs, #healthcare insurance companies will continue this practice.
Please add other #PBM policies on covering #opioid analgesics if u have them.
#healthcare
#HealthInsurance
#SundayThoughts
It's problematic when one's Dr issues Rx based on individual health care needs & PBM, ins co, tries to dictate/change Rx &/or outright denies coverage.
They do this with other medications too, including #insulin. #Congress & state legislators speak up & advocate for people with #Diabetes & other diseases when this happens. They just don't bother with tens of millions of Americans w #ChronicPain #intractablepain #RareDiseases.
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