A half-century into the “war on drugs,” with a new wave of opioid addiction at crisis proportions, some commercial health insurers are beginning to cover methadone maintenance, the oldest and best-researched treatment for addiction to heroin and prescription pain relievers.

4 Jul 2017

Independence Blue Cross, the Philadelphia region’s largest insurer, will join the emerging trend in August, offering complete coverage with no co-pays. There are spaces available at local methadone clinics and the treatment is considered highly effective.

But it also is controversial — substituting one drug for another, perhaps for life — and cumbersome, typically requiring daily visits to a clinic. And methadone maintenance, which historically has been publicly funded, long has been stigmatized as serving the most hard-core addicts and the poor. Communities often fight to keep new clinics from opening.

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No one has any idea how many middle-class policy-holders — who are more drawn by newer (and much more costly) drugs for opioid addiction that don’t require daily clinic visits —  will take advantage of methadone coverage. The larger impact, several people who work in the field said, may be to help lift the reputational cloud from methadone maintenance.

Richard Snyder, chief medical officer at Independence Blue Cross, said the need became clear to him as he heard people testify about the horrors of addiction while he served on Mayor Kenney’s opioid task force a few months ago. Methadone costs pennies a day. But even the most expensive treatments are cheaper than the consequences of a downward spiral of opioid use, Snyder said.

“From a business perspective it’s logical to do it, and from a social standpoint, it’s imperative that we treat people,” he said.

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