title: Insurance company denial of payment and enforced changes in the type and dose of opioid analgesics for patients with cancer pain.
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.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston, Texas.
authors.forename: Kimberson
authors.initials: K
authors.lastname: Tanco
authors.affiliation: Blizzard & Nabers LLP,Houston, Texas.
authors.forename: Sofia E
authors.initials: SE
authors.lastname: Bruera
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston, Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000701:Analgesics, Opioid / Q000191:economics* / Q000592:standards / Q000627:therapeutic use; D006801:Humans; D007342:Insurance Benefits / Q000191:economics / Q000592:standards*; D007345:Insurance Claim Review / Q000191:economics / Q000592:standards*; D009369:Neoplasms / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D010146:Pain / Q000188:drug therapy* / Q000191:economics; D059408:Pain Management / Q000191:economics* / Q000379:methods
chemical_list: D000701:Analgesics, Opioid
keywords: Barriers to pain management; Cancer pain; Insurance coverage; Insurance denial; Opioid analgesic