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Insurance company denial of payment and enforced changes in the type and dose of opioid analgesics for patients with cancer pain

Published online by Cambridge University Press:  17 April 2014

Kimberson Tanco ,
Sofia E. Bruera  and
Eduardo Bruera
Kimberson Tanco*
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Sofia E. Bruera
Affiliation:
Blizzard & Nabers LLP, Houston, Texas
Eduardo Bruera
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
*
Address correspondence and reprint requests to: Kimberson Tanco, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030. E-mail: kctanco@mdanderson.org
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Abstract

Opioids are the mainstay of treatment for moderate to severe cancer pain. The variations in average monthly cost can make it difficult for most patients to procure them without adequate insurance coverage. There are increasing numbers of denials of payment and statements made by insurance agents and other sources regarding inappropriate opioid use, resulting in severe pain and emotional distress for cancer patients and their families. This case series describes five events where the insurer was a major barrier to opioid access.

Keywords

Cancer painOpioid analgesicInsurance denialBarriers to pain managementInsurance coverage
Type
Case Report
Information
Palliative & Supportive Care , Volume 12 , Issue 6 , December 2014 , pp. 515 - 518
Copyright
Copyright © Cambridge University Press 2014 

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