However, it adds that “every drug plan that covered lidocaine patches, which are not addictive but cost more than other generic pain drugs, required that patients get prior approval for them.” In addition, nearly all plans covered common opioids, with very few requiring prior approval for them to be prescribed. Also, insurers have placed additional barriers between the approval of addiction treatments than they have in place for the addictive substances those treatments are aimed at.

The report cites an example of a woman being treated with Butrans whose insurer, UnitedHealthcare, stopped covering the drug in January. Butrans had cost UnitedHealthcare $342 for a four-week supply, the report says, while the drug that the patient finally ended up with after an unsuccessful appeal is long-acting morphine.

Not only did UnitedHealthcare not question the morphine prescription, but its cost to the insurer is just $29 for a month’s supply.

UnitedHealthcare has said that the patient has not yet exhausted the appeal process to receive Butrans and that it “will work with her physician to find the best option for her current health status.”

Dr. Thomas R. Frieden, who led the Centers for Disease Control and Prevention under President Obama, is quoted in the report saying that insurance companies, with few exceptions, had “not done what they need to do to address” the opioid epidemic. He adds that at present it’s easier for most patients to get opioids than to receive treatment for addiction.

The Department of Health and Human Services is also looking at whether insurance companies make opioids more accessible than other pain treatments.

Experts studying opioid abuse are also concerned about insurers’ limits on addiction treatments. And the analysis of Medicare plans also found that restrictions are prevalent there as well — either via requirements for prior authorization or prohibitive out-of-pocket costs for the drugs that treat addiction.