The Health Section

Aetna sets five-year goals to fight opioid epidemic

Aetna is aiming to reduce inappropriate opioid prescribing to members by 50 percent by 2022.

The company is also aiming to increase evidence-based multi-modal approaches when treating members with chronic pain and using medication assisted treatment (MAT) for members with opioid use disorder by 50 percent by 2022.

“These goals are Aetna’s North Star – they are benchmarks against which all of our opioid efforts will be measured and the standard to which we hold ourselves accountable,” said Harold L. Paz, M.D., M.S., executive vice president and chief medical officer for Aetna.

Aetna’s goals are a part of the company’s larger, comprehensive strategy to combat the opioid epidemic. In Aetna’s opioid strategy paper published in June 2017, Paz writes how the company is using data analytics, clinical insights and collaborations to drive improved outcomes.

“We’re working to prevent misuse and abuse, intervene when we identify at-risk behavior and support those who are addicted through evidence-based treatments,” Paz wrote.

Aetna created an enterprise-wide opioid task force in 2016, which is chaired by Paz. The task force is made up of representatives from various business areas, such as Health & Clinical Services, Pharmacy, Dental and Behavioral Health, and meets monthly.

In 2016, Aetna analyzed its claims data to identify over 1,000 physicians, who were super-prescribers, or an over-prescriber, of opioids. Those physicians were sent letters warning them of their prescribing patterns and given educational information. In 2017, Aetna continued the initiative and identified and sent letters to over 1,000 dentists and oral surgeons that were over-prescribing opioids to patients.

Note: Data only includes Aetna commercial and Medicare members.

The company also removed the pre-certification of burprenorphine products in 2016, increasing access to treat opioid use disorder.

Aetna is also enhancing its Controlled Substance Use Program, which identifies patients who might misuse or abuse opioids. The program also allows Aetna to alert prescribers and reach out to the member to offer help.

The company also alerts pregnant Medicaid members at risk for neonatal abstinence syndrome, which occurs in newborns who experience withdrawal from opioids they were exposed to in the womb.

Note: Data only includes Aetna commercial and Medicare members.

The various initiatives have resulted in a reduction in opioid prescriptions.

Based on data from the first quarter of the year, Aetna estimates there will be 8,958,842 opioid prescriptions filled in 2017 among its commercial and Medicare members – a 10.85 percent decrease from 2016. The company is also estimating an 11.9 percent decrease of members with an opioid prescription in 2017, compared to 2016.

Note: Data only includes Aetna commercial and Medicare members.

In May 2017, six U.S. senators reached out to Aetna to learn more about what the company is doing to confront the opioid crisis. In his reply, Aetna Chairman and CEO Mark T. Bertolini outlined numerous programs and initiatives Aetna has in place to prevent, identify and combat addiction.

Read more information and details on how Aetna is fighting the opioid epidemic.