Naloxone (Narcan): What Workers Comp Payers Need to Know

Though it has been on the market since 1971, this year is expected to be a landmark year in Naloxone (Narcan) sales nationwide, and this trend is expected to continue due not only to the opioid epidemic sweeping the nation, but the fact that opioids still remain the most frequently prescribed category of medication used in workers’ comp pain management.

Preventing Death from Opioid Overdose

In its hallmark form, Naloxone was approved for injection by the FDA in 1971. An opioid agonist, it was used in hospital and emergency settings to temporarily reverse the dangerous effects of overdose, including sedation, low blood pressure, and potentially fatal respiratory depression. However new outpatient options have recently entered the market, putting this potentially life-saving drug in the hands of the general public.

• Evzio (2014)
  The first FDA-approved naloxone auto-injector available in the U.S., this small, portable device, similar in nature to an Epi-pen, can be used by patients or family members in the event of overdose. (Holds a significantly higher average wholesale price than Narcan and traditional injectables.)
• Narcan (2016)
  A single-dose, ready-to-use nasal spray that requires the patient to be lying on their back for proper administration.

Not a Magic Bullet
Reversing the effects of opioids at the receptor site and blocking further binding, naloxone takes effect in 3 minutes, wearing off in about 30-to-90 minutes depending on the opioid taken. Though it reverses the clinical and toxic effects of overdose, it only displaces opioids for a short time.

Access Expanding
Despite its short-term effects, legislative and regulatory reforms are making naloxone increasingly available nationwide as states struggle to combat the opioid epidemic. Anesthesiologists, PMR physicians, physician assistants, nurse practitioners and pain management specialists are writing the majority of prescriptions for patients undergoing opioid treatment therapies. Civil liability protection has been expanded for First Responders employing its use. Some states have even made naloxone available for sale as an over-the-counter medication.

Turn the Tide
Due to opioid over-prescription and abuse in our country, Naloxone is unfortunately a necessary medication. However, at ANS Solutions, we believe the best way to prevent opioid overdose is by circumnavigating its use with the patient-doctor education and equally effective, scientifically-proven alternative medical treatments that protect the outcome of injured workers, and reduce unnecessary opioid treatments and associated costs. With our medical cost containment strategies, safe, efficacious cost-effective care is possible. Discover more at http://www.ans-solutions.com today.

Sources: http://helioscomp.com/docs/default-source/continuing-education-2016/072816-optum-naloxone-use-in-wc-ce_final.pdf 

Original content posted on http://ans-solutions.com/naloxone-narcan-what-workers-comp-payers-need-to-know/

The Impact of Workers Compensation Compounding

As custom-made compound prescriptions concoctions continue to rack-up higher workers’ compensation costs, insurers are scrambling to find alternatives and employers are looking for relief from equally inflated premiums. With little to no evidence as to the efficacy of such creations, many states have implemented treatment guidelines directing doctors to more evidentiary-based, easily reimbursable options. Despite guidelines and formularies however, loopholes in coverage continue to allow providers to sell millions of dollars of compounds, with many companies submitting inflated reimbursement bills in their attempts to get paid.

A Growing Issue in Workers Compensation

This June, the U.S. Attorney’s Office brought criminal charges against such providers across the country, accusing them of defrauding the Medicare, Medicaid, and Tricare health insurance programs that serve the military and their families. Additionally, the Inspector General of the U.S. Postal Service identified compound drugs as attributable for 34% of the postal service’s prescriptions, and 53% of prescription drug costs in 2015, a rise from 22% and 27% in 2014, respectively. State and federal prosecutors also continue to finger some pharmacies for offering doctor kickbacks in exchange for prescriptions.

Money or medicine?

Industry guidelines point to the use of such compounds as a last resort, accepted in instances where a person is allergic to an ingredient in a drug, or when a liquid version of a commercially available drug is necessary for one who cannot swallow capsules. Some doctors prescribe initially despite these guidelines. The unnecessary prescription of compounds is costing the workers’ comp industry billions annually.

Deep impact

2015 calculations indicate…

• Re-packaged drugs dispensed by physicians cost employers 60% to 300% more than those dispensed at retail pharmacies.
• The average paid per compound drug increased by more than two-thirds from $460.00 to $774.00, though non-compound drugs fell slightly from $113.00 to $108.00.
• The U.S. Postal Service alone spent a whopping $390,000.00 a day for compound drugs in 2015.

Tired of paying more for ineffective treatments?
Proven, more affordable, clinically tested and approved options to compounds do exist. It’s time to find a better way. Discover how to achieve better claims outcomes with ANS Solutions Pharmacotherapy Review. Contact http://www.ans-solutions.com today.

Original content posted on http://ans-solutions.com/the-impact-of-workers-compensation-compounding/

Prescription Drugs and the Workers’ Compensation Arena

The U.S. remains the biggest global consumer of prescription drugs, up from around 76 million in 1991 to nearly 207 million in 2013 however a recent court ruling has called into direct question the prescription practices of physicians nationwide (Volkow).

The occurrence of unnecessary or medically inappropriate prescribing of opioids in pain management is compromising the lives and well-being of injured workers.  There are a number of serious issues concerning the use of opioids in pain management:

• Not cost effective
  Evidence-based reviews are seldom consulted prior to the prescribing of opioids, and a lack of appropriate physician monitoring and/or patient compliance further contributes to longer recovery periods and increased cost.
• Increased drug-drug interactions
  Polypharmacy, the use of 4 or more medications simultaneously with opioids, can result in drug-drug interactions with severe consequences for patient health.
• Risk for Addiction and Abuse
  The highly addictive nature of opioids leads to the necessity of higher doses over time, resulting in cost increase and greater risk of overdose/addiction. .
• Lack of evidence for proven benefit
  Recovery and return to work rates are not improved by the use of opioids in pain treatment. The American Academy of Neurology and a number of states have released product guidelines advising physicians to proceed with caution when initiating opioid therapy for pain or long-term use.

• Dose dependent risks for serious harm
  Physicians and patients are not always properly educated on use and good faith prescription practices and guidelines, including risks of remaining on disability, addiction, drug-drug interactions, and dosages at which death and risk of overdose dramatically increase.

Where do we go from here?
It’s never been more obvious than now that effective pain treatment must focus on the legitimacy and efficacy of treatments, keeping in mind the quality of care and quality of life of injured workers.  At ANS Solutions our pharmacotherapy review program is focused on protecting the injured worker by:

• Better addressing the needs of pain patients with the assessment of treatment programs and help of evidence based reviews.
• Improving recovery times with the proper monitoring and modifications of treatment.

• Reducing the risks associated with common opioid treatment regimens by consolidating and coordinating drug therapies between multiple prescribers, identifying duplicate therapies and excessive dosages, and pointing out alternate medication regimens.

Positive change stems from a comprehensive and economically responsible approach in the treatment of pain in workers compensation claims settlements. To learn more about pharmacotherapy review contact ANS today.

References

Volkow, Nora D. Prescription Opioid and Heroin Abuse, House Committee on Energy and Commerce Subcommittee on Oversight and Investigations. https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/prescription-opioid-heroin-abuse;  April 29, 2014.

Original content posted on: http://ans-solutions.com/prescription-drugs-and-the-workers-compensation-arena/

6 Benefits of ANS Legal Nurse Consulting Services

The specialized skill-set of legal nurse consultants can play a crucial role in claim settlement and medical legal cases. Here we review six benefits of the services provided by ANS’s highly credentialed and experienced legal nurse consultants:

1) Critical Analysis

Through the critical analysis of medical records, our nurse experts summarize critical events in a case’s history to identify issues such as causality, scope of damages, and standards of care. By analyzing medical causation and exposure they effectively gauge merits of alleged injuries while identifying any missing medical information that may prove valuable to a claim.

2) Collaboration

Multiple parties must be engaged to successfully determine a modified course of treatment, and ensure compliance to the new course of treatment. Legal nurse consultants play an instrumental role in securing the collaboration between prescribing physicians, attorneys and injured workers which optimizes the negotiation and settlement of a claim.

3) Strategic Assessment

Through the exhaustive and strategic assessment of each case, ANS nurse experts uncover causation, mitigating factors, unreasonable medical charges and inappropriate patterns of care while also potentially exposing unnecessary or unrelated care issues. There assessments lead to a recommended course of action that not only improves the living conditions of the injured worker but reduces pharma costs by 25% or more.

4) Legal Support  

Attorneys may call legal nurse consulting experts as witnesses at trial to provide facts, data and opinions based on case evidence. If needed, legal nurse consultants may also locate and retain expert witnesses with specialized insight and knowledge relevant to the circumstances of a case.

5) Education

In the process of deciphering a case, legal nurse consultants educate attorneys regarding medical facts, timelines, treatments, nursing terminology and other relevant health care information. Furthermore, their legal nurse consultant degree and experience gives them the background to bridge the gap between law and medicine.

6) Research

Research is encompassed in every aspect of legal nurse consulting. The research support generated by legal nurse consultants can provide an extraordinarily powerful legal instrument in the negotiation of a claim.

ANS Legal Nurse Consulting

With a background in professional nursing education, training, and clinical experience to the assessment of standards of care, causation, and damages, the support of ANS legal nurse consultants can significantly optimize medical legal case and claim outcomes. To find out more about how an ANS nurse expert can impact your bottom line contact us today or visit www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/6-benefits-of-ans-legal-nurse-consulting-services/.