Is Cost the Main Barrier to Reducing Pain Pill Prescriptions?
I recently ran across a fascinating STAT news piece discussing chronic pain and the fact that western medicine seems incapable of reducing the number of pain pill prescriptions issued by doctors. The piece goes on to explain that cost could be the biggest barrier. It is not that other treatments do not exist. It’s that they cost more than prescription pain pills.
Being neither a medical professional nor someone who fully understands the business side of medicine, I don’t claim to comprehend everything that goes into determining how a doctor will treat a patient for pain. Yet the arguments made in the STAT piece are compelling.
Another New Pain Pill
The article leads off with a brief discussion about a new pain pill currently awaiting FDA approval. Apparently, the pill is as effective as opioids but with little to no risk of addiction. It is the pain pill’s version of getting your cake and eating it too. But do we need yet another prescription medication for pain? Authors Antje M. Barreveld and Edin Randall do not think so.
Barreveld is a pain medicine specialist and anesthesiologist at Newton-Wellesley Hospital. Randall is a pediatric psychologist and an assistant professor of psychiatry and behavioral science at Harvard. As professionals who deal with persistent pain on a daily basis, they are fully aware that other treatments exist.
In their article, the authors reference studies showing that there are other ways to treat persistent pain. The options include physical and occupational therapy, mind-body and behavioral strategies, good sleep, nutrition, and even group support. But if studies show that alternative treatments work, why aren’t they being fully utilized?
According to Barrevald and Randall, it boils down to cost. The alternative treatments are more expensive because they require the time and effort of psychologists, therapists, and pain medicine doctors. It is a lot cheaper for an insurance company to cover a prescription for pain pills.
Money Is the Downside of Our System
Our healthcare system is a profit-driven system. That is not necessarily a bad thing. Profit drives innovation and progress. It creates competition that drives everybody to be better. But the downside to our system is the ongoing desire for more money. Profit is a good motivation when kept in check. But when left unchecked, it leads to patients not being treated very well.
To me, it is unconscionable that a health insurance company would willfully ignore proven treatments in order to save money on less expensive treatments that don’t work as well. The idea that carriers would rather cover pain pill prescriptions is astounding to me.
The clinicians at Lone Star Pain Medicine in Weatherford, TX are quick to explain that treating persistent pain is rarely successful when the only therapy is a prescription. Painkillers only go so far. And when the pills a person is prescribed have a high potential for addiction, pain is often the least concern that patient has.
Pain pills have another big disadvantage: they don’t get to the root cause of pain. Medications only mask what a patient is feeling. But what if physical therapy could address the root cause and help a patient feel better? Why not utilize it? That is the million-dollar question.
More Than One Way
The truth is that pain is very personal. There is no black-and-white formula for treating it because the pain experience differs so greatly from one patient to the next. Unfortunately, western medicine prefers the one-size-fits-all approach of writing prescriptions. Could that be because drugs are cheaper? At least two experts in the field think so.
