Covey Emarie L, Belvedere Lindsay M, Barnes Michael D
Background: From 2000-2014, Utah experienced a 400% increase in opioidrelated deaths and currently ranks 4th in the nation for such deaths. To address this problem, a policy was recently proposed by the Utah State Legislature that would require insurance prior authorization (PA) for certain high dose, long-acting opioid prescriptions. The purpose of this study is to analyze potential health impacts of the policy and to determine whether it would be an effective step in combatting Utah’s opioid problem.
Methods: A rapid Health Impact Assessment (HIA) was performed to assess the potential health impacts of the proposed policy. Hypotheses were generated and a causal pathway was developed. Quantitative and qualitative data were gathered to assess each hypothesis and determine the direction, magnitude, likelihood, and distribution of each potential health impact.
Results: Several positive and negative health impacts of the policy were examined. Negative health impacts that are likely include increased time and cost for prescribers, and increased patient stress and anxiety due to difficulties in filling prescriptions. Positive health impacts include a modest decrease in the amount of opioids prescribed and a modest decrease in opioid consumption, leading to a decrease in the number of persons addicted to prescription opioids.
Conclusion: Given the potential for the proposed PA policy to decrease the number of opioid addicts, it is recommended that the Utah State Legislature move forward with the proposed policy. However, in order to mitigate potential negative health effects, it is recommended that pain specialists be exempt from opioid-related PA.
