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Blue Cross Blue Shield Association Affirms Opioids Should Not Be Prescribed as First or Second Lines

Professional standards require alternative therapies designed to limit harm to Blue Cross and Blue Shield members

Chicago – The Blue Cross Blue Shield Association (BCBSA) National Council of Physician and Pharmacist Executives (NCPE) at its March meeting adopted a professional standard that opioids should not be prescribed as first or second lines of pain therapy in   most clinical situations.

The standard was unanimously supported by the NCPE, a committee that includes medical officers and pharmacy experts from Blue Cross and Blue Shield (BCBS) companies around the nation, and aligns with recent CDC guidelines. It is designed to limit unnecessary harm for the 106 million members served by BCBS companies. BCBS companies will promote alternatives that include more optimal use of non-opioid prescription painkillers and existing over-the-counter pain medications.

“Due to the lack of evidence combined with significant potential for harm, we believe professional standards require that BCBS members are given alternative options to opioids in most clinical situations,” said Dr. Trent Haywood, chief medical officer for BCBSA. “We will work with medical professionals to ensure BCBS members are routinely provided alternatives to opioids through a mutual decision made inside the doctor’s office.” 

Twenty-one percent of BCBS commercially insured members filled at least one opioid prescription in 2015, according to a BCBSA study. The report also showed members with an opioid use disorder diagnosis spiked 493 percent over a seven-year study period.

All BCBS companies cover non-opioid pain treatment options, as well as medication-assisted treatments. Around the country, BCBS companies are providing services like training for doctors and pharmacists, customized coaching services for those with chronic pain and support for families in addiction recovery. 

"The impact of opioids in this country has been well documented," Haywood added. "Because Blue Cross and Blue Shield companies represent one in three Americans in diverse communities with diverse needs, we are taking a comprehensive approach to addressing the opioid epidemic through prevention, intervention and treatment.”

For additional information regarding how BCBS companies are addressing the opioid epidemic, please visit

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