Medicaid Coverage of Medications to Treat Alcohol and Opioid Dependence

Abstract Substance use disorders affect 12% of Medicaid beneficiaries. The prescription drug epidemic and growing need for treatment of alcohol and opioid dependence have refocused states' attention on their provision of substance use disorder treatment services, including medications. This stu...

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Bibliographic Details
Published in:Journal of substance abuse treatment 2015-08, Vol.55, p.1-5
Main Authors: Mark, Tami L., Ph.D, Lubran, Robert, M.P.A, McCance-Katz, Elinore F., M.D, Chalk, Mady, Ph.D., M.S.W, Richardson, John, M.P.H
Format: Article
Language:English
Subjects:
Alcohol
Alcohol Deterrents - therapeutic use
Alcohol use
Alcohol-Related Disorders - drug therapy
Buprenorphine, Naloxone Drug Combination - therapeutic use
Drug abuse
Financing health care
Humans
Insurance coverage
Insurance Coverage - statistics & numerical data
Lifetime treatment limits
Medicaid
Medicaid - statistics & numerical data
Methadone
Methadone - therapeutic use
Naltrexone - therapeutic use
Narcotic Antagonists - therapeutic use
Narcotics - therapeutic use
Opioid
Opioid-Related Disorders - drug therapy
Preferred drug lists
Psychiatry
Substance abuse treatment
Taurine - analogs & derivatives
Taurine - therapeutic use
United States
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Summary:Abstract Substance use disorders affect 12% of Medicaid beneficiaries. The prescription drug epidemic and growing need for treatment of alcohol and opioid dependence have refocused states' attention on their provision of substance use disorder treatment services, including medications. This study characterized how Medicaid programs cover these treatment medications. Data were from 2013 Medicaid pharmacy documents, 2011 and 2012 Medicaid state drug utilization records, and a 2013 American Society of Addiction Medicine survey. Results showed that only 13 state Medicaid programs included all medications approved for alcohol and opioid dependence on their preferred drug lists. The most commonly excluded were extended-release naltrexone (19 programs), acamprosate (19 programs), and methadone (20 programs). For combined buprenorphine–naloxone, 48 Medicaid programs required prior authorization, and 11 programs used 1- to 3-year lifetime treatment limits. Given the chronic nature of substance use disorders and the overwhelming evidence supporting ongoing coverage for many of these medications, states may want to reexamine substance use disorder benefits.
ISSN:0740-5472
1873-6483
DOI:10.1016/j.jsat.2015.04.009