Aetna To Waive Narcan Co-Pay, Limit Opioid Prescriptions

By Kelly Burch 12/14/17
The health insurer believes that eliminating co-pays might lead more people to have access to the potentially life-saving drug.
woman holding Narcan nasal spray
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The insurance company Aetna announced this week that it will try to combat the opioid crisis by eliminating co-pays for the opioid overdose reversal drug Narcan and limiting durations of first-time opioid prescriptions. 

“Aetna is committed to addressing the opioid crisis through prevention, intervention and treatment,” Harold L. Paz, MD, MS, executive vice president and chief medical officer of Aetna, said in a press release. “Increasing access to Narcan can save lives so that individuals with opioid abuse disorder can live long enough to get into evidence-based treatment.”

The changes will take effect on January 1st, according to CNN Money. On average, Aetna prescribers pay a $30 to $40 copay for a dose of Narcan, although some pay as much as $150. The company has found that people who have a higher co-pay are less likely to pick up their prescriptions for Narcan, suggesting that eliminating co-pays might lead more people to have access to the potentially life-saving drug, which doctors prescribe when they believe a patient might be at risk for overdosing. 

“Cost is clearly a factor in whether individuals with substance abuse disorder obtain medication that could save them from a fatal overdose,” Paz said. “By eliminating this barrier, we hope to keep our members safe until they are ready to address their addiction.”

Some of Aetna’s customers—those who are self-insured, meaning that their employers only use the company for administrative services—will not have access to the waiver. However, about 4.6 million customers will be able to access Narcan without a co-pay. 

In addition to making Narcan more widely available, Aetna will begin limiting opioid prescriptions for acute pain to seven days. That means that patients who are recovering from things like surgery or dental procedures will not be able to access long-term prescriptions. 

A CDC study found that each day someone is on opioids the chance of addiction increases, hence limiting first-time prescriptions is believed to be an effective step toward cutting the risk of addiction. In September, CVS Pharmacy announced a similar plan to issue only one week’s worth of opioid pills in cases of acute pain. 

'We are further strengthening our commitment to help providers and patients balance the need for these powerful medications with the risk of abuse and misuse,” Larry J. Merlo, president and CEO of CVS Health, said at the time. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.