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Naltrexone and pharmacy benefit management.

Katherine M Harris¹, Cindy Thomas

¹The Office of Applied Studies, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857, USA. kharris@samhsa.gov

Journal of Addictive Diseases

|September 2, 2004

Summary

Naltrexone for alcohol dependence is widely covered by insurance, but restrictions like prior authorization limit its use. Improving access to this medication is key for effective alcohol treatment.

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Area of Science:

Pharmacoeconomics
Health Services Research
Addiction Medicine

Background:

Naltrexone, approved by the FDA in 1994, offers potential for effective and accessible alcohol dependence treatment.
Despite its benefits, naltrexone utilization remains low, influenced by factors affecting general prescription medication adoption.
Third-party coverage and formulary inclusion are critical for the diffusion of new pharmaceutical technologies.

Purpose of the Study:

To examine drug benefit design and formulary coverage issues impacting naltrexone adoption.
To assess naltrexone coverage by major health insurance programs and pharmacy benefit managers.
To determine if drug benefit design acts as a barrier to naltrexone use in alcohol dependence treatment.

Main Methods:

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Review of current drug benefit design principles and formulary decision-making processes.

Analysis of publicly available data on naltrexone coverage across various health plans.

Examination of coverage restrictions, such as quantity limits and prior authorization requirements.

Main Results:

Naltrexone demonstrates broad formulary coverage across public and private health plans.
Restrictions on naltrexone use, including quantity limits and prior authorization, are frequently implemented.
While coverage exists, these restrictions may impede patient access and treatment adherence.

Conclusions:

Naltrexone is generally accessible through insurance formularies for alcohol dependence.
Common restrictions on naltrexone use, such as prior authorization, may hinder its widespread adoption.
Addressing formulary restrictions is essential to enhance naltrexone's role in alcohol treatment.