 Professional society founded in 1954 representing 3,100+ physicians & other associated professionals  Mission:  Increase access to & improve the quality of addiction treatment  Educate physicians, other health care providers & public  Support research & prevention  Promote appropriate role of the physician in patient care  Establish addiction medicine as a recognized specialty

May 2011: Dr. Mark Publicker, an ASAM addiction specialist physician, alerted ASAM to Maine legislation that limits patient access to addiction medications. April 2012: ASAM Board of Directors appointed a Patient Advocacy Task Force (PATF) to advocate for patient access to evidence- based, cost-effective medication treatment for opioid dependence. June 20, 2013: PATF Stakeholder Summit at The National Press Club in Washington, DC; Report results are disseminated. September 30, 2013: ASAM Hill Briefing on pharmacotherapy for opioid addiction treatment. October 23, 2013: ASAM Legislative Day on Capitol Hill; ASAM members bring awareness of the issue to policymakers.

 State Medicaid survey of coverage & access  Commercial insurer survey of coverage & access  Literature reviews of clinical and cost- effectiveness of stabilizing medications to treat opioid addiction  TRI and Avisa Group research results available on ASAM’s website (

 Every state Medicaid program covers at least one of the FDA-approved medications  Many state Medicaid programs have implemented authorization requirements which must be met prior to payment for these medications  Requirements for approval range from limited to severe, and may include “fail first” policies or a history of frequent service utilization

 Inclusion in a plan’s formulary does not equate to easy access  Utilization Management (UM) can reduce access  Most common UM requirements are:  Prior authorization  Quantity and dosage limits  Step therapy or “fail first” requirements

 Most widely available is Suboxone & new formulations may make it even more available  Generic formulation approved by the FDA in March, 2013, is available in about 50% of plans studied  While methadone is available in Opioid Treatment Programs (OTPs), ASAM’s study found no commercial coverage

 All medications are FDA approved (methadone*)  Hundreds of effectiveness studies  All medications have demonstrated modest or better cost effectiveness in maintenance  No evidence for effectiveness in detoxification  All medications are under-utilized

 All reports and resources are available online at s-for-Opioid-Addiction-Treatment s-for-Opioid-Addiction-Treatment