BOSTON — The largest health insurer in Massachusetts has cut prescriptions of narcotic painkillers by an estimated 6.6 million pills in 18 months as part of a campaign to curb abuse.

The decline in prescribed opiates including Percocet and Vicodin followed the insurer’s decision to limit the quantity of narcotic painkillers members could obtain without prior approval by the company, Blue Cross Blue Shield of Massachusetts, said its president, Andrew Dreyfus.

The insurer implemented changes in July 2012 that have reduced prescriptions by 20 percent for common opioids including Percocet, and 50 percent for longer-lasting drugs including OxyContin, Dreyfus told The Boston Globe.

Dreyfus says the program is the first of its kind in the state and possibly the country.

Blue Cross decided to revise its regulations after an internal review showed that more than 30,000 of its members received prescriptions lasting longer than 30 days for drugs such as Percocet and Vicodin.

If more medication is requested beyond the new limits, the patient must be assessed for the risk of addiction and a treatment plan must be agreed upon by the prescriber and the patient.

Cancer patients as well as clients with terminal illnesses who generally need painkillers for longer periods are exempted from the stricter limits. Other insurers in Massachusetts said they also have safeguards to fight painkiller abuse. Dr. Ronald Dunlap, president of the Massachusetts Medical Society, said Blue Cross is heading in the right direction, but suggested statewide standards rather than every insurer implementing its own rules.

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