Companies driving down opioid prescriptions while overdoses are on the rise

Madison-area companies are finding ways to drive down the number of opioid prescriptions while overdoses are on the rise statewide.

Kiio is a business with a digital therapeutic system for managing back pain. CEO Dave Grandin, speaking at a Wisconsin Technology Council discussion held in Madison yesterday, said Kiio is helping employers save money on their health plans while improving outcomes for patients.

In a recent partner study with Quartz, Kiio brought in volunteer patients and split them between one group using the Kiio platform and another without it.

“We really were looking for what’s happening with their pain over time,” Grandin said. “We found great results for that. We looked in their claims data to see what was happening with procedures and processes… We also looked at what’s going on with opioids.”

He says Kiio users had a 78 percent reduction in opioid prescriptions, compared to 2 percent for the non-Kiio users.

Tim Bartholow, chief medical officer of Madison insurance company WEA Trust, says the opioid epidemic is “touching our communities in ways we can actually impact.”

He pointed to Kiio’s system as one solution relied on by WEA Trust.He also highlighted other strategies pursued with some success. The insurer has been testing a method where first-time opioid patients get one week of medicine, rather than an entire month as is sometimes the case. Refills are then dispensed on a case-by-case basis, often after a conversation on the dangers of opioids.

That strategy led to a 27 percent reduction in pills delivered to the company’s 105,000 members, Bartholow said.

But UW-Madison Professor Aleksandra Zgierska notes that as the number of filled opioid prescriptions have decreased in Wisconsin, the number of opioid overdoses has been on the rise.

She said the 27 percent reduction mentioned by Bartholow matches the overall Wisconsin data. The state’s prescription drug monitoring database shows an approximately 30 percent reduction in opioid prescribing in the past year, she said.

“On the surface it sounds great,” she said. But at the same time, she notes Wisconsin was “leading the pack” for rising overdose admissions to emergency departments.

“There is this discrepancy between what we hear and what we see,” she said. “When you are reducing prescribing, there are more overdoses and potentially more overdose deaths. How do you reconcile these data?”

She notes that as some patients have had their opioid doses reduced or cut off completely, they turn to illicit sources such as heroin. That can help explain, she says, how the state can be doing so well on one front, but falling short on another.

Zgierska suggested one way to help fix this complex problem is reducing stigma by paying closer attention to how addiction is discussed. That can lead to people being more comfortable with asking for help, rather than trying to go it alone.

“Using the word abuser, and abuse — it’s stigmatizing. Nobody wants to be an abuser, and they are not abusers,” she said. “They have a disease, the disease of addiction. Which we know is a chronic brain disease.”

Grandin said Kiio’s platform can act as a “digital wall,” helping avoid some of the stigma.

“Removal of stigma — that’s very, very important, and that’s the very large piece that technology and digital tools can play,” he said. “It doesn’t remove the human factor; it just enhances the human factor.”

–By Alex Moe