Asam s advancing access to stabilizing medications
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ASAM’s Advancing Access to STABILIZING Medications PowerPoint PPT Presentation


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ASAM’s Advancing Access to STABILIZING Medications. American Society of Addiction Medicine (ASAM). Professional society founded in 1954 representing 3,100 + physicians & other associated professionals Mission:

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ASAM’s Advancing Access to STABILIZING Medications

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Asam s advancing access to stabilizing medications

ASAM’s Advancing Access to STABILIZING Medications


American society of addiction medicine asam

American Society of Addiction Medicine (ASAM)

  • Professional society founded in 1954 representing 3,100+ physicians & other associated professionals

  • Mission:

    • Increase access to & improve the quality of addiction treatment

    • Educate physicians, other health care providers & public

    • Support research & prevention

    • Promote appropriate role of the physician in patient care

    • Establish addiction medicine as a recognized specialty


Advancing access to stabilizing medications

Advancing Access to Stabilizing Medications


Asam sponsored research

ASAM-Sponsored Research

  • State Medicaid survey of coverage & access

  • Commercial insurer survey of coverage & access

  • Literature reviews of clinical and cost- effectiveness of stabilizing medications to treat opioid addiction

  • TRI and Avisa Group research results available on ASAM’s website (www.asam.org)


Asam state medicaid survey results

ASAM State Medicaid Survey Results

  • Every state Medicaid program covers at least one of the FDA-approved medications

  • Many state Medicaid programs have implemented authorization requirements which must be met prior to payment for these medications

  • Requirements for approval range from limited to severe, and may include “fail first” policies or a history of frequent service utilization


Coverage of fda approved stabilizing medications

Coverage of FDA-Approved Stabilizing Medications


Lifetime limits on buprenorphine prescriptions

Lifetime Limits on Buprenorphine Prescriptions


Commercial insurer findings

Commercial Insurer Findings

  • Inclusion in a plan’s formulary does not equate to easy access

  • Utilization Management (UM) can reduce access

  • Most common UM requirements are:

    • Prior authorization

    • Quantity and dosage limits

    • Step therapy or “fail first” requirements


Commercial findings cont d

Commercial Findings (cont’d)

  • Most widely available is Suboxone & new formulations may make it even more available

    • Generic formulation approved by the FDA in March, 2013, is available in about 50% of plans studied

  • While methadone is available in Opioid Treatment Programs (OTPs), ASAM’s study found no commercial coverage


Tri review of effectiveness conclusions

TRI Review of Effectiveness: Conclusions

  • All medications are FDA approved (methadone*)

    • Hundreds of effectiveness studies

  • All medications have demonstrated modest or better cost effectiveness in maintenance

  • No evidence for effectiveness in detoxification

  • All medications are under-utilized


Research resources

Research & Resources

  • All reports and resources are available online at http://www.asam.org/docs/advocacy/Implications-for-Opioid-Addiction-Treatment


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