Gateway OxyContin Guidelines

Effective and safe pain management is a goal of healthcare professionals who treat patients suffering from chronic pain; a goal shared by Gateway Health Plan^®. It is estimated that 35% of Americans experience chronic pain, making it one of the more common conditions for which people seek medical treatment.

Gateway Health Plan^® has implemented quantity limitation guidelines for OxyContin, thereby limiting the maximum number of tablets allowable to 60 tablets per month. Review of data and trending across Pennsylvania Medicaid Health Care plans confirms that the implementation of tablet quantity limitation guidelines for OxyContin does not impede effective pain management. Endorsed by our Pharmacy and Therapeutics Committee and approved by Department of Public Welfare, these established quantity limitation guidelines for OxyContin will not limit access of OxyContin to Gateway Health Plan^® members, but rather ensure safe and appropriate pain management therapy.

Below is a chart designed to serve as a quick reference for conversion of doses between the long-acting opioid analgesics. This chart is a starting point to estimate dosage. Adjustments still need to be made based on the patient’s previous history of opioid use, or lack of, and subsequent dosing needs to be monitored and adjusted accordingly.