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Reductions in care, prior authorization common for patients with pain
More than 80% of physicians said they were required to reduce the quantity and/or dose of medication prescribed to a patient with pain, according to a new survey of pain medicine physicians by the American Board of Pain Medicine (ABPM) (PDF). The survey also found that 88% of pain medicine physicians said that they have been required to submit a prior authorization for non-opioid pain care—with the physicians and their staff spending hours per day on such requests. These figures are similar to previous ABPM surveys in 2018 and 2019.
“As pain medicine physicians, it is our responsibility to ensure we provide our patients with the best and most appropriate care,” said Scott Davidoff, MD, President of ABPM. “Part of that is active engagement in the effort to ensure appropriate opioid prescribing. This most recent survey (PDF) again shows that while our patients are having opioid medications reduced or denied, they are left with few options and many barriers to receiving the care they require. It is imperative that all stakeholders work with us to revise policies that are detrimental to our patients.”
The AMA recently reported that opioid prescriptions have decreased by more than 44% between 2010-2020.
The ABPM gave several policy recommendations to help patients with pain:
- Amend opioid-restriction policies to allow for exceptions that enable physicians, when in the physician’s judgment to be medically necessary, to exceed statutory, regulatory or other thresholds
- Expand reimbursement policies to cover non-opioid treatment options including pharmaceutical pain care options, physical and occupational therapy, interventional pain management procedures, CAM, psychological support, mindfulness and substance abuse treatment (and place on the lowest cost-sharing tier for the indication of pain)
- Remove administrative barriers to non-opioid pain care such as prior authorization
- Continue COVID-19 policies that allow for greater use of telemedicine to ensure increased flexibility for patients with pain to obtain necessary medications and other treatments
- Recognize ABPM Board certification as a valued and respected designation for physicians practicing pain medicine that is equivalent to ABMS certification
For more information about the survey, please contact the ABPM’s Carolyn B. Armour.
