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Volume 12 - September 2018

The Invisible Crisis:
Understanding Pain Management in Medicare Beneficiaries with Sickle Cell Disease


Sickle cell disease (SCD) is the most prevalent genetic blood disorder in the United States, with an estimated 100,000 people living with SCD. This disease, which disproportionately affects Blacks and Latinos, causes the body to produce abnormal blood cells shaped like crescents or sickles rather than discs. These sickle-shaped cells have trouble properly delivering oxygen to body tissues, which causes extraordinarily painful and severe attacks known as a crisis.


This study highlights variability in opioid prescribing among Medicare beneficiaries with SCD. For the majority of patients with SCD, opioid analgesics were an important treatment option, and a subset utilized doses of greater than 120 MME to manage SCD-related pain. The complex nature of SCD pain management may be exacerbated by ongoing efforts to address the opioid epidemic. Excluding sickle cell patients from efforts to restrict opioid access, similar to exclusions for cancer, hospice patients, and other patients with complex pain syndromes, could help ensure that sickle cell patients have ac­cess to appropriate care that improve patient health outcomes. As new pain management options are identified, the needs of patients living with SCD should be considered.

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10/01/2018 10:21 AM