Florida Blue Medicare, Prime Therapeutics Work Together to Reduce Opioid Overuse

Dr. Cynthia Griffin

By Dr. Cynthia Griffin – During the COVID-19 pandemic, drug overdose deaths increased 15% to over 107,000 Americans in 2021¹. with the overwhelming majority involving opioids, according to the CDC. Florida Blue Medicare, the state’s Blue Cross and Blue Shield Medicare plan, recently announced results of a pilot program designed to help save the lives of Medicare members and their families with access to their medications. Through a collaboration with pharmacy benefit manager Prime Therapeutics, members who participated in the program took fewer opioid medications, contributing to a lower risk for addiction and more lives saved.

As part of the pilot program, at-risk Florida Blue Medicare members were identified using predictive modeling based on member claims data and Prime’s opioid registry. The program emphasized education and safety for two groups, both of which had positive outcomes:

New opioid users consumed less, stopped earlier


Members with new opioid prescriptions received information that described what an opioid is, how they work and how to safely use and dispose of them, as part of the pilot program.

  • New users consumed a significantly smaller quantity of opioids, using 37% fewer morphine milligram equivalents (MME) than the control group. (An MME is an opioid dosage’s equivalency to morphine and is used to help clinicians make safe, appropriate decisions concerning opioid regimens.)
  • New users also voluntarily stopped using opioids at a higher rate while in the study, with 29% more new users stopping as compared to the control group.

Use by existing opioid users declined


Members who had an existing opioid prescription, as well as their doctors, received information about the safe use and disposal of opioids. The material also encouraged members to speak with a doctor or pharmacist about naloxone, a medicine that reverses an opioid overdose in an emergency.

  • One out of 10 members in the group stopped using opioids through the follow-up period. This resulted in a 7% reduction in opioid prescriptions and a 2.8% increase in naloxone prescriptions.

Florida Blue has taken an aggressive approach to fighting the opioid crisis in Florida. Through its Opioid Task Force, launched in 2016, the company has set into motion a number of key initiatives to significantly address the issue, including working with our pharmacy partners.

“We are committed to reducing opioid overuse by helping our members find other ways to effectively manage their pain, providing education and offering other innovative solutions. Prime Therapeutics has been an important ally in this fight,” said Cynthia Griffin, PharmD, vice president, Medicare pharmacy programs at Florida Blue Medicare. “The results of this pilot are very encouraging. By using data to create customized programs for our members, we can positively contribute towards the reduction of opioid abuse in our community and potentially save lives.”

Based on the positive results of this pilot, Florida Blue Medicare and Prime Therapeutics have plans to expand their opioid management programs to help more members and their families.

About Florida Blue Medicare
Florida Blue Medicare is committed to helping our Florida neighbors live healthier. We offer a wide range of plan options, including Medicare Advantage plans, to give our members what they need to live their best lives and improve their overall health and well-being. Headquartered in Jacksonville, Fla., Florida Blue Medicare is built for Florida’s seniors and proud to be affiliated with Florida Blue, a health insurer that has served Floridians for over 75 years. Florida Blue and Florida Blue Medicare are Independent Licensees of the Blue Cross and Blue Shield Association. Learn more at FloridaBlue.com/Medicare.

About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime provides total drug management solutions for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and offers clinical services for people with complex medical conditions. Prime serves nearly 33 million people. It is collectively owned by 19 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. For more information visit primetherapeutics.com or follow @Prime_PBM on Twitter.

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