Opioids Still the Top Prescribed Drug in California

Using data derived from the 10.8 million workers comp prescriptions dispensed between January 2005 and December 2014, a recently released report by the California Workers’ Compensation Institute identified opioids as the number one prescribed drug in California’s workers’ compensation system.

Report findings indicate that opioid prescriptions accounted for 27.2% of total prescribed pharmaceuticals. In addition, the average cost of opioid prescriptions rose by 85% from $61 to $113. In comparison, other prescription drugs within the same time frame experienced only a 39% increase, from $94 to $131. The report also indicated the proportion of injured workers prescribed opioids within the first 24 months following injury increased from 22.4% in 2005, to 27.9% in 2010.

Some positive trends were revealed however - in 2014, opioids dispensed to injured workers in the state dropped to 27.2%, from a 2009 peak of 31.9%. Also, the impending implementation of a statewide formulary is expected to contribute to reduced opioid use.

At the end of the day however, opioid use is still excessive. While prescription drug monitoring programs have been a focus of California state regulators, other California Workers’ Compensation Institute studies of utilization review have shown that medical management resources in California have been disproportionately directed to the review of requests for opioids and pain management drugs.

In workers’ compensation pain management, opioids continue to be prescribed in situations where their use may not be entirely appropriate, increasing the patient’s risk of addiction or overdose. ANS’s pharmacotherapy review program has been highly successful in uncovering overprescribing and ineffective management of patient treatment plans not just in California but across the country. The work of our legal nurse experts lays the ground work for pain treatment regimens that reduce the financial costs of large loss claims, while improving quality of care and life for injured workers.

To learn more about are success rate in California, contact ANS Solutions today.

This content was originally posted at http://ans-solutions.com/opioids-still-the-top-prescribed-drug-in-california/

Sources:

Hayes, Steve, Swedlow, Alex. “California Workers’ Compensation Institute: Trends in The USE of Opioids in California’s Workers’ Compensation System,” May 2016.

Putting the Injured Worker First

In the workman’s comp industry, significant effort is put toward breaking the pharmaceutical cost cycle for Payers. As the industry fights for savings, however, injured workers often get lost in the shuffle. The nameless and faceless many among worker’s comp injury statistics are quite removed from the system they rely upon.

Bottom Line Statistics Means Poor Outcomes for Injured Workers

As political pundits fight for special interests, benefit caps are set with no relation to each state’s average weekly wage, ignoring improved wage data and analytical methods that could mend take-home benefits in favor of maintaining the status quo. In addition, research undertaken by the worker’s comp industry often passes over the injured workers themselves, focusing on bottom-line statistics. Typical drug utilization review programs further compound this focus, overlooking patient and prescriber history and offering little to no treatment compliance monitoring, thus yielding poor outcomes for all parties involved.

There is a silver lining however, organizations such as the Workers’ Compensation Research Institute (WCRI), the California Workers’ Compensation Institute, and the National Council for Compensation Insurance are attempting to remove the industry’s blinders with improved studies centered on cost containment and service delivery, offering evidence based data on medications, surgeries and providers in an effort to improve care for patients while curtailing costs.

Ensuring the Best Possible Outcomes

ANS’s Pharmacotherapy Review offers more than clinically-proven drug alternatives that reduce Payers’ costs. Our three pronged approach to claim management is much more comprehensive than the industry standard drug utilization review. Improving the quality of life and care of the injured worker is a driving force behind the development of our proprietary pharmacotherapy review program.

• Focusing on the well-being of the injured worker.
• Consolidating and coordinating drug therapies by multiple prescribers to uncover unnecessary or duplicate treatments.
• Providing alternate therapies with less associated risk factors.
• Uncovering potential risk addiction behaviors.
• Offering weaning programs to help combat the over-prescription of narcotics (opioids).

Embrace change for the betterment of all. Find out more about our innovative drug utilization program today by visiting www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/putting-the-injured-worker-first/

CDC Opioid Guidelines Sheds Light on Conflicting Expert Opinions

The CDCs latest opioid prescribing guidelines, released this March, were created with the goal of achieving balance between the analgesic and addictive properties of opioid analgesics, to uphold the safety as well as meet the pain management needs of the public at large. Unfortunately, the controversy surrounding these guidelines points to a detrimental issue at the crux of their implementation: A fractured field – two expert, yet conflicting, schools of thought on the current opioid policy.

• Treating chronic pain with a wider range of treatments, as opposed to relying mainly on opioid regimens.
• Avoiding the use of high dose prescriptions, as well as the combined prescription of opioids and benzodiazepines, to reduce the risk of overdose.
• Providing addiction treatment when necessary (methadone, buprenorphine).

There are two conflicting schools of thought regarding treatment approaches to opioids…

1. Reduce Pain and Suffering.
   This paradigm stems from an aggressive movement in the 1990s wherein physicians trained in pain management and palliative care were instructed to be sympathetic to pain. Enforced by the belief that those in true pain would not become addicted and reinforced by pharmaceutical companies and federal agencies pointing to pain as “the fifth vital sign,” this movement missed the boat on understanding the serious risks of opioid addiction.
2. Prevent and Treat Addiction.
   Driven by addiction specialists, who lacked an understanding of the seriousness of debilitating and chronic pain and whose priorities were vastly different than pain and palliative care physicians, practitioners of this model had a more thorough understanding of the addictive risks of opioid regimens. They watched the sales of opioid prescriptions quadruple from 1999-2010 - alongside the rate of overdose deaths. Though the need for a rapid public health response remained apparent, insufficient evidence on safe stoppage procedures for opioid regimens existed. Dissention among experts as to the seriousness of the problem and how to address also further muddied the waters.

The Fulcrum between Analgesia and Addiction

Though the CDC’s recently released guidelines are as strong as they can currently be, opioid pain treatment regimens – and addiction treatments – continue to be a work in progress. The fractured nature of this field reflects the reason changes were such a long time coming. A multidisciplinary approach will be as essential to working out the kinks as they were to the development of the CDC’s recently released guidelines, as all parties involved strive to save lives and ensure quality of care.

Are you looking for more advanced and comprehensive medical cost containment strategies that protect patient outcomes while also reducing the costs associated with pain management in workers compensation claims? ANS Solutions’ pharmacotherapy review program can help.

This content was originally posted at http://ans-solutions.com/cdc-opioid-guidelines-sheds-light-on-conflicting-expert-opinions/

Key Takeaways from a Recent National Safety Council Survey

Subsequent to the CDC’s new guidelines regarding the treatment of chronic pain, The National Safety Council (NSC) released its latest survey regarding doctor prescribing practices. Summarized below, the statistics:

CDC Guidelines: Use non-opioid therapies first.
NSC Stats: 74% of doctors erroneously believe opioids (morphine, oxycodone) are the most effective way to treat pain.

The Missing Link: Research shows OTC pain meds (ibuprofen, acetaminophen) offer the most effective relief for acute pain.

CDC Guidelines: Do not use opioids for the routine treatment of chronic pain.
NSC Stats: 67% of doctors base there prescribing practices – in part – on patient expectations.

The Missing Link: Patients are often unaware – and doctors wary to inform them – of the effectiveness of alternative treatments for pain. 50% of those patients would return to those prescribers offering alternative treatment.

CDC Guidelines: No longer than 3 days of opioid treatment, beginning with the lowest effective dose.
NSC Stats: 99% of doctors are prescribing these highly addictive drugs for longer than the CDCs recommended time frame – 23% for at least a month.
The Missing Link: Though doctors have the best interests of patients at heart, additional education and training on effective pain management are integral to curbing the rising opioid epidemic.

CDC Guidelines: Address harms of opioid use and assess risk for abuse prior to opioid therapy.
NSC Stats: 84% screen for abuse.
The Missing Link: Only 32% screen for a family history of addiction – a strong indicator.

CDC Guidelines: Re-evaluate risks of continued therapy regularly.
NSC Stats: 99% of doctors have seen a pill-seeking patient – only 32% refer pill-seekers to treatment.
The Missing Link(s): 88% of doctors find referrals overly difficult due to patient unwillingness to cooperate, lack of insurance coverage for such treatments, long wait lists, or lack of providers.

Actionable Treatment Recommendations

ANS's Pharmacotherapy Review Program employs a three staged approach to ensure economically balanced and appropriate treatment options for injured workers. Our legal nurse experts are able to present actionable treatment modification recommendations in a written proposal to treating physicians. Key items of interest covered through the recommendations include:

• Consolidation and coordination of drug therapies between multiple prescribers.
• Consideration of alternate therapies.
• Specification of weaning programs for over-prescribed narcotics.
• Use of generics where applicable.

The end result is a cost effective treatment regimen that simultaneously enhances the quality of care for injured workers. To find out more contact ANS today.

This content was originally posted at http://ans-solutions.com/key-takeaways-from-a-recent-national-safety-council-survey/

Prescription Drug Abuse Knows No Bounds

Earlier this month, the American public was shocked by the untimely death of iconic pop legend Prince. Though autopsy results remain unreported, media coverage alleges that Prince was struggling with a prescription pill addiction to Percocet, receiving treatment for an opioid overdose just days before his death.

This post is not to re-hash celebrity news from various gossip reports but rather to point out the depth and breadth of the prescription drug epidemic. In the past decade, Whitney Houston, Heath Ledger, Brittany Murphy, Anna Nicole Smith and Michael Jackson were just a few other celebrities to overdose on legally prescribed medication. These very public deaths reflect a larger wave of prescription drug abuse across the United States, something ANS has touched on frequently in our blog posts.

A Proactive Approach to Patient Care

There seems to be a false sense of security that accompanies the use of doctor prescribed pain killers- the risk of addiction may not be stated clearly enough or is just not taken seriously.

At the end of the day opioid addiction knows no boundaries, spanning all races, ages, genders and income levels.

When it comes to chronic pain treatment, a focus on the education of well-being of the injured worker is crucial. That is why ANS developed pharmacotherapy review – not only as a medical cost containment strategy for payers, but as a proactive approach to minimizing inappropriate, duplicate or unnecessary treatment regimens, as is often seen with opioid based prescription pain killer treatment regimens.

Through in-depth reviews of each patient’s medical history alongside the assessment of the practices of prescribing physicians, our legal nurse experts are able to uncover underlying illnesses, behaviors and risks, and then implement actionable recommendations to existing treatment plans, addressing potential issues before they can lead to serious adverse events.

Concerned about the growing opioid epidemic and how it’s contributing to treatment outcomes and your large loss workman’s comp claims? We can help, contact ANS today at www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/prescription-drug-abuse-knows-no-bounds/

Effective Pharma Management Can Help Offset Increases in Prescription Costs

2015 saw rising drug prices contributing to the growth in pharmacy spending for American workers’ compensation payers. Meanwhile, opioid and compound drug cost management continues to be an Achilles heel. An effective pharma cost management program can offset these costs by aiming to improve pain treatment regimens for injured workers.

Pharmacotherapy Review Can Reduce Opioid Spend

Opioids continue to be the costliest class of medications for occupational injuries. To combat the rise in opioid utilization in chronic pain treatment of injured workers, ANS introduced a face-to-face and highly proactive approach to addressing pain physician prescribing practices.  Known as Pharmacotherapy review, it starts with an extensive review of the injured workers’ medical history along with their existing pain treatment regimen and historical physician treatment practices. An ANS Legal Nurse expert with intimate case familiarity visits the doctor in person at their office and negotiates an evidence supported pharmacy regime in a face-to-face and collaborative interaction. The treatment recommendations agreed to during this process not only contribute to reduced opioid prescriptions but often enhance the quality of care and life for injured workers with more risk averse and often more appropriate treatment alternatives.

Combating Rising Compounded Medication Costs

In 2015, the average cost for payers of compounded medications per prescription hovered around $2,000. The cost is high and so are the risks to patients:

• Compounded drugs are not federally regulated and product quality assessments are lacking unlike their FDA-approved counterparts.
• Compounded drugs are not clinically evaluated for safety or efficacy.
• Compounded preparations do not have standard product labeling or prescribing information with instructions for safe use.
• Compounding pharmacies are not required to report adverse events to the FDA
• Potential errors in the preparation of compounded drugs can and have caused adverse effects on patients.

Due to the unnecessary risks compounded drugs pose to patients these products are not considered first-line therapies in the treatment of injured workers. ANS Solutions leads the way in providing medical cost containment strategies that help our clients ensure that pain treatment therapies are appropriate, safe and economically responsibly. By managing compounded medications, clients can reduce unnecessary costs and mitigate the potential harmful effects to patient safety caused by pain physician prescribing habits.

Optimized Financial and Patient Outcomes

ANS medical cost containment programs work uniquely to address these and other legal issues that ensure the most rapid and cost reduced settlement of claims in the industry. Our proven strategies are so effective we offer a 1 million dollar pilot program performance guarantee, completely risk free.  To learn more contact us today or visit www.ans-solutions.com.

 

This content was originally published at http://ans-solutions.com/effective-pharma-management-can-help-offset-increases-in-prescription-costs/

2016 WCRI Annual Issues & Research Conference

ANS recently attended the 2016 WCRI Annual Issues & Research Conference. The independent, not-for-profit institute studies and delivers objective information pertaining to public policy issues involving the workers’ comp system.

Conference Panel Highlights:

• Opioid Prescribing in Workers’ Comp
  • Overview:
    Opioids are a societal problem – not just a workers’ comp issue, and it will take a decade to dig ourselves out. Guidelines are necessary to combat the growing trend.
  • Positive Trends:
    Prescription frequency varies widely by state, leading to revised prescribing guidelines in medical/workers’ comp communities. Retail pharmacies are no longer simply filling, but verifying diagnosis/necessity. The DEA/FDA are also reclassifying some medications to reflect abuse potential, and activist groups supporting change are emerging.
  • Negative Trends:
    A major problem in the workers’ comp arena, the need for early intervention/monitoring is being overlooked by employers, and subsequently programs. Conflicting guidelines also cause confusion. Additionally, use of heroin, the cheaper alternative to prescription opioids, is on the rise.
  • Goals:
    Curtail chronic opioid use and ensure appropriate prescribing of opioids to injured workers and avoid unintended results by boosting awareness of the issue.
• Opioid Dispensing and Use
  • Overview:
    Yet-to-be published studies reveal the impact of pricing reforms for opioid dispensing physicians.
  • Physician Dispensing:
    Following reforms, prices decreased in most states, with fewer prescriptions dispensed. In IL and FL prices substantially increased – because physicians switched to formulations not covered in fee schedules. Price/amounts of pharmacy-dispensed products remained constant.
  • Variations in Use:
    Three-of-four injured workers nationwide receive opioids for pain. LA, NY, and PA dispense significantly higher amounts; NY and PA higher dosages. Patients who received opioids also received benzodiazepines in WI, MI, CT and MA. Per claim amounts decreased from 2012-2014, and frequency of drug testing increased significantly.

As an industry leader in large loss workers compensation claim management, ANS is setting the pace for drug utilization review with our proprietary Pharmacotherapy Review, helping fight the trend of the over-prescription of narcotics. Contact http://www.ans-solutions.com today.

This blog was originally posted at http://ans-solutions.com/2016-wcri-annual-issues-research-conference/