from the Institute for Patient Access
Two new publications make it clear: Patients in pain need access to integrative, comprehensive care.
Newly adopted policies from the American Medical Association say that utilization management policies such as prior authorization should be opposed if they are not rooted in evidence.
The AMA points out that insurers’ and pharmacy benefit managers’ use of utilization management techniques limit non-opioid treatment options. Prior authorization, for example, keeps patients from receiving non-opioid and complementary approaches such as topical lidocaine patches, massage or acupuncture.
And the AMA is hardly the only organization that sees the value in a more balanced approach to pain management. The association’s resolution comes on the heels of a final report from the Department of Health and Human Services’ Pain Management Best Practices Inter-Agency Task Force. The report identifies ways to improve individualized, patient-centered care for Americans in pain.
“Addressing barriers to access to care is essential in optimizing pain care,” the report notes. “Improved insurance coverage and payment for different pain management modalities is critical to improving access to effective clinical care,” it continues, pointing out the significant impact that barriers to care have on patients.
Regardless, gaps in access persist.
Opioid prescriptions have fallen in recent years, in part because of federal guidelines from the Centers for Disease Control and Prevention. But insurers’ response to calls for access to balanced pain management approaches has not been as prompt. As a result, patients in pain may struggle to get the care they need. And patients who do rely on prescription opioids as part of their pain management regimen may find it difficult to find a physician who will treat them.
Whether addressing acute or chronic pain, an individualized treatment plan is key. And access to multiple treatment modalities is necessary for this ideal to become a reality. Advancing recommendations, whether from the AMA or the HHS task force, requires government policymakers and health insurers to take action.