FEBRUARY 27, 2020

Advancing Quality | Making Healthcare Simpler

In recent years, the opioid epidemic has touched just about every corner of the nation, and although great strides have been made in reducing the number of deaths from overdoses, tens of thousands of people are still dying each year and many more are becoming addicted. Additionally, according to a recent report by the Society of Actuaries, between 2015 and 2018 the financial burden of the opioid epidemic for U.S. employers was $96 billion dollars due to lost productivity associated with absenteeism, presenteeism, incarceration for opioid-related crimes and the costs for disability and workers’ compensation benefits for employees who misused opioids.

For 31 percent of adolescents (10-19 years old) their first exposure to opioids is following a dental procedure, which makes dentists a significant source of opioid prescriptions for an age group that is potentially vulnerable to drug abuse and addiction. Because dentists are often at the frontlines of prescribing opioids, there are tremendous opportunities to work with them to fight against opioid addiction. In 2016, after the CDC issued its guidelines for all clinicians on opioid prescribing, the American Dental Association (ADA) released its updated guidelines to advise dentists to limit prescribing opioids and recommend alternative pain management options. However, a recent study found that dentists still wrote 18.1 million prescriptions for opioids in 2017. This demonstrates that guidelines alone aren’t the solution to addressing this issue and a system-wide approach is needed.

A Whole Health Approach to Control Opioid Prescribing

We believe that the gravity of the opioid epidemic required a bold approach, which is why our integrated approach to whole person health allowed Anthem to employ our combined Pharmacy and Dental strengths to develop a solution. Immediately after the CDC guidelines were issued, our Pharmacy business aligned with the CDC’s recommendations and implemented stronger quantity limits on short-term and long-term acting opioids, which included those prescribed by our network dentists.

At the same time, we further developed our whole person health approach, which connects dental, vision, pharmacy, disability and medical claims data into a real-time, patient health profile. Through the platform, we were able to share prescription and utilization data across our Medical, Pharmacy and Dental lines of business and we initiated a multi-year effort to create more targeted communications for network dentists who had a higher volume or longer duration of opioid prescriptions. We also broadly educated our network dentists about effective non-narcotic opioid alternatives like non-steroidal anti-inflammatory drugs (NSAID).

Giving Dentists an Integrated View of a Patient’s Health History

In the fall of 2019, we launched the Dental Patient Health History Tool, a first-of-its-kind solution that gives our network dentists access to view integrated patient health histories, including what other opioid prescriptions are being filled in order to avoid potential overprescribing. Anthem is the only health benefits company to share important health and clinical data in real time, so our network physicians, dentists and vision doctors can better coordinate and deliver a personalized approach.

Progress in Reducing Opioid Prescriptions

Since 2016, when we announced our three pillar strategy (prevention, treatment and deterrence) and our goals for reducing opioid prescriptions, we have made great progress across our entire organization. For our Dental line of business, I am proud to share that Anthem’s collective efforts have shown incredible results. Over the last four years, we have seen more than a 50 percent reduction of opioids prescribed by dentists. During the same time period, we have seen a reduction in the number of opioid prescriptions by dentists exceeding a 7-day supply by over 90 percent.

As a leader in healthcare, we know we have a responsibility to do what we can to combat this epidemic, save lives and reduce the financial burden to businesses and communities. Our deliberate and purposeful approach harnesses the power of real-time benefit integration, and engages and educates our network dentists about non-narcotic alternatives and their opioid prescribing patterns. We are committed to whole person care and I believe our work with the dental community and success in reducing the number of opioids prescribed demonstrates how effective we can be when we work together.