Monday, July 24, 2017

Government Struggles to Hold Opioid Manufacturers Accountable



For the first time ever, the U.S. DEA targeted a prescription drug manufacturer for their role in black market opioids and damages incurred. Mallinckrodt Pharmaceuticals, one of the largest national manufacturers of the highly addictive generic painkiller oxycodone, one of the leading drugs responsible for the more than 15,000 overdose deaths in 2015, was accused of shirking its responsibility to report suspicious drug orders.

Who’s to Blame For The Opioid Epidemic?


Created at Mallinckrodt’s Hobart, NY facility, oxycodone shipped via its distributor network, including KeySource, Sunrise Wholesale and Cardinal Health, who later supplied the pills to retailers, including pharmacies and hospitals accused of illegally diverting the drugs. Discovered in a 2009 Tennessee Drug Task Force sting and linked back to Mallinckrodt’s distributors Florida retailers, 2010-2011 DEA investigations uncovered large amounts of Mallinckrodt oxycodone – such as the 41 million KeySource Medical oxycodone tablets delivered to Florida retailers in 2010 – about 2.5 pills for every man, woman and child in the state. Accused of splitting orders to conceal shipment amounts, KeySource was ordered by the DEA to halt, later relinquishing its distribution license. Distributors Sunrise Wholesale and Cardinal Health likewise delivered vast quantities of Mallinckrodt’s oxycodone to pharmacies in Florida. 500 million Mallinckrodt pills ended up in Florida from 2008-2012 — 66% of state oxycodone sales. A 2011 subpoena following this the discovery further revealed, 6 weeks after the Tennessee task force alerted Mallinckrodt to the drugs found in the 2009 sting, Mallinckrodt shipped another 2.1 million tablets their Sunrise distributor, 92,400 tablets of which were sold to Dr. Barry Schultz, the Delray Beach doctor whose oxycodone was found in Tennessee. Schultz was later convicted of drug trafficking and manslaughter (for a related overdose death). In one day, he prescribed 1,000 tablets to a single patient. Ultimately, the DEA and federal prosecutors alleged Mallinckrodt ignored its responsibility to report suspicious orders, in violation of the Controlled Substances Act.

Shirking Responsibilities?

Under federal law and DEA policy, pharmaceutical companies are required to “know their customers,” monitoring amounts, frequencies, and patterns of drug orders, immediately notifying the DEA of suspicious activity – or risk losing their license to manufacture and sell controlled substances, as well as civil and criminal penalties. Though Mallinckrodt maintained publicly the company has worked hard to fight drug diversion, internal case summaries prepared by federal prosecutors indicated Mallinckrodt’s response was that ­‘everyone knew what was going on in Florida but they had no duty to report it.’ Sources familiar with settlement talks indicated Mallinckrodt acknowledged its responsibility to report suspiciously large orders, but contended the DEA did not require manufacturers to know about (or be responsible for) ‘their customers’ customers,’ further pointing to conflicting DEA advice as to legal responsibilities. Prosecutors considered a whopping 43,991 unreported orders from distributors and retailers suspicious.

Uncharted Waters

Appalled by the rising opioid death toll, the DEA’s push to hold drug manufacturers accountable was hoped to be a wake-up call, putting the industry on notice for its responsibilities in the diversion of drugs to the black market. Instead, after years of industry investigations spanning five states to build the massive case, the results mirrored the DEAs previous attempt to hold wholesale distributors accountable. The case stalled. Fierce company resistance and intense lobbying efforts may have played a role in the lack of legal action pursued. The case settled for $35 million in fines and no admission of wrongdoing.

Small Potatoes

The proposed settlement, a mere fraction of the 44,000 federal violations pointed to in the investigation which could have cost the company $2.3 billion in fines, amounts to small potatoes for a company that posted $3.4 billion in revenue and $489 million in profit in 2016. In a later February 2017 SEC filing, Mallinckrodt even noted the investigation “will not have a material adverse effect on its financial condition” because it had set aside the funds.

About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ comp insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.

SOURCES:
https://www.washingtonpost.com/graphics/investigations/dea-mallinckrodt/?_hsenc=p2ANqtz-9DxkF3wbuslmavvDf3o8CSw_0KLDObRAx7Ah4JgQ2Vi7_84yvAVhoUcmcpQyMQ-LDuL7935zGFyhc7J8njQ-cALSVCEg&_hsmi=51277531&utm_campaign=Rx%20Summit&utm_content=51277531&utm_medium=&utm_source=hs_email&utm_term=.ebaec91ff136
http://www.reuters.com/article/us-mallinckrodt-settlement-idUSKBN1751JM
https://www.opensecrets.org/lobby/clientsum.php?id=D000022900

Original content posted on http://ans-solutions.com/government-struggles-to-hold-opioid-manufacturers-accountable/ 


Monday, July 10, 2017

Can States Surpass Federal & Address Big Pharma?


With some states and areas across the country on the receiving end of opioid painkiller prescription shipments that outnumber the people housed therein, state officials are beginning to address the link between the opioid crisis, Big Pharma, and the heavy burden weighing on their municipalities. In an attempt to hold Big Pharma accountable, they’re taking a page out of past lawsuits against tobacco companies – and suing them.

Key Players

Until now, these multibillion dollar companies have been sidelined in the fight against the opioid epidemic. Now they’re being looked at as star players by city, county, state, and federal officials – even the DEA has taken notice, responding in-kind. This year, in a push to hold opioid manufacturers and distributors responsible, multiple lawsuits have been launched…

States Join Forces in the Fight Against Opioids

Taking the lives of 40 Americans each day, the total economic burden of prescription opioid overdose is costing the country $78.5 billion per year – and these states are taking action…
  • Missouri
    Most recently, Missouri’s filed suit against 3 opioid manufacturers, alleging a deliberate campaign of fraud to convince doctors and the public against the highly-addictive, life-threatening potential of the drugs.
  • Mississippi
    Suing Purdue Pharma and 7 others, Mississippi lawsuits are borrowing tactics used in their successful fight against tobacco companies in 1998, alleging companies misrepresented the dangers of opioids to doctors and patients, marketing the drug as rarely addictive, and a safe substitute for non-addictive pain medications like ibuprofen or naproxen. But pharmacy companies don’t want the suit to go through – not until FDA-ordered studies on long-term risks/benefits are completed, which could take several years.
  • Ohio
    Ohio filed suit against multiple manufacturers for false advertising, Medicare fraud, and violation of the Ohio Corrupt Practices Act, claiming the companies knew (or should have known) their drugs weren’t safe or effective.
  • Illinois
    Illinois is taking part in multi-state investigations into manufacturers, with 2 lawsuits in-play. One against Insys, for the deceptive marketing of highly-addictive Subsys for the off-label treatment of back and neck pain in efforts to gain huge profits. Another, an anti-trust suit against the makers of Suboxone, used to treat opioid addiction, alleging a scheme to block generics to artificially inflate prices.
  • East Tennessee
    Prosecutors representing 9 counties are taking aim at Big Pharma using the Tennessee Drug Dealer Liability Act, or ‘crack tax’ law. Designed to hold dealers criminally and financially responsible for the effects of the drugs they distribute, the suit labels drug makers as dealers, further accusing them of lying about the addictive properties of opioids, aggressively pushing them as miracle cures for all types of pain. The state AG is investigating its options in pursuing its own legal action.
  • New York
    8 NY counties have joined in seeking compensation for expenses caused by the state’s growing drug problem, alleging marketing omitted critical information about the addictive nature of the drugs and risks associated with long-term use.
  • Everett, Washington
    They city of Everett filed suit against Purdue Pharma, makers of OxyContin, alleging the company was intimately aware its drug was being funneled into the black market, yet did nothing.

Distributors Sinking, Similar Challenges Against Manufacturers Possible 

CVS, Walgreens, Walmart, McKesson, Cardinal Health, KeySource, Sunrise Wholesale and more are facing charges and paying fines – sometimes multiple times. Some suits have settled. Others have resulted in criminal convictions. Could Big Pharma be next? Though manufacturers vigorously reject the argument they’ve fueled the current opioid crisis, it’s hard to ignore the overdose deaths – more than 300,000 since 1999. But opioids (opium, morphine, heroin) have been around, literally, for centuries, and their highly-addictive properties well-known.

More Lawsuits On the Way

Lawyers currently working these cases note a growing number of jurisdictions showing interest. States are joining forces in the current investigation, with dozens more lawsuits expected. The ultimate hope? That if enough attorneys general are able to join forces in bringing suits, they can accomplish what the federal government has been unable to… And snowball the lawsuits into a massive settlement that might finally put an end to practices that have fueled the deadliest drug overdose crisis in U.S. history.

About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ compensation insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.

Sources:
https://www.vox.com/policy-and-politics/2017/6/7/15724054/opioid-companies-epidemic-lawsuits
https://www.theatlantic.com/business/archive/2017/06/lawsuit-pharmaceutical-companies-opioids/529020/
https://www.levinlaw.com/government-opioid-lawsuit
https://www.washingtonpost.com/national/the-drug-industrys-answer-to-opioid-addiction-more-pills/2016/10/15/181a529c-8ae4-11e6-bff0-d53f592f176e_story.html?utm_term=.a364db6d5fe7

Original content posted on http://ans-solutions.com/can-states-surpass-federal-address-big-pharma/

Monday, June 26, 2017

How Does Doctor Shopping Impact The Opioid Epidemic?


Surprisingly, the non-medical prescription of drugs, including opioids, continues, with only states holding legislation against this dubious practice smothering the flames helping stoke the opioid addiction fire. Since 1999, deaths from prescription opioids have quadrupled, alongside opioid sales of painkillers such as oxycodone (Oxycontin) and hydrocodone (Vicodin). But this hasn’t stopped opioid abusing patients from trying to nab a couple of extra pills by ‘doctor shopping,’ the practice of hopping from physician to physician and playing the numbers until finding a doctor who will meet the patient’s desire for a few extra pills. Luckily states nationwide, alongside the insurance and healthcare community, are becoming increasingly aware of these issues, and are attempting to stem this contributing facet of the epidemic through the use of prescription drug monitoring programs (PDMPs). And a new study has shown them astonishingly successful.

An Easy-to-Use, Effective Means of Curbing ‘Doctor Shopping’


Physicians utilizing these state-run electronic prescription databases, mandatory in some states and voluntary in others, offers them access to each patients prescription history, and the opportunity to see drug types and quantities prescribed to patients before breaking out the prescription pad. In addition to thwarting potentially deadly drug interactions and excessive dosages, a recent study has shown that these programs are highly effective for reducing the non-medical prescription of drugs, boasting a whopping 80% reduction in the odds two (or more) doctors would dole out pain relievers for non-medical reasons to a single patient in states with mandatory PDMP use, and slashing the odds 56% in states with voluntary participation. Every state except Missouri now has one of these programs. Other studies have also shown states tracking a wider range of potentially addictive medications and updating databases weekly witnessed the biggest reduction in overdose deaths.

Won’t Patients Turn to Illicit Substances?


Public health advocates have had this worry for quite some time, but the current study pointing to the massive, 80% reduction in non-medical prescription of opioids in those states with mandatory programs also uncovered some reassuring news. PDMPs did not, in fact, lead to an increase in doctor shopping individuals turning to heroin. This offers hope for the promise of PDMPs as part-and-parcel of a multifaceted, comprehensive strategy toward fighting the nation’s opioid epidemic, which steals the lives of 91 Americans each day.


About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ comp insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.


Original content posted on http://ans-solutions.com/how-does-doctor-shopping-impact-the-opioid-epidemic/

Wednesday, June 14, 2017

Medical Marijuana Vs. Big Pharma


Increasingly gaining ground as an accepted medicine by top health associations, researchers, and medical journals, the marijuana industry continues its massive expansion, with legalization encompassing more than half the U.S. Predicted to expand nationwide by 2021 by investment firm The Motley Fool, other sectors of the economy are feeling the strain of the industry’s new growth – but no one greater than Big Pharma.

Marijuana & Pharmaceutical Market Share

In an effort to determine how cannabis cash flow is effecting the pharmaceutical industry, researchers at the University of Georgia uncovered just how much of the pharmaceutical pie is being gobbled-up in medical marijuana states – and the results were stark: The average doctor in cannabis-friendly states prescribed 265 fewer dosages of antidepressants, 486 less anti-seizure meds, 541 fewer anti-nausea doses, 562 less anti-anxiety meds, and a whopping 1,826 less doses of pain medications, saving the government’s Medicare Part-D program an estimated $165 million on prescription pills. Taking that total nationwide, an estimated $470 million would disappear from Big Pharma’s annual revenue from this avenue alone.

Expanding Data on Marijuana & Opioids Worrisome for Pharma

A 2014 JAMA study stated opiate overdoses dropped roughly 25% in states with legalized medical marijuana, implying patients may be using it for pain treatment – or to lessen their painkiller load. According to according to the report in Drug and Alcohol Dependence, legalization states also failed to see the expected influx of pot smokers through hospital doors – instead experiencing a decline in hospitalization rates for opioid abuse and overdoses, which dropped 23% and 13% respectively, on average.

Fighting Legalization While Simultaneously Developing Synthetic Cannabis Drugs

This big dip in pharmaceutical purchases is hitting Big Pharma hard, and combined with industry interests, is fueling massive donations to anti-marijuana campaigns, making Purdue Pharma (OxyContin) and Abbot Laboratories (Vicodin) some of the largest contributors to the Anti-Drug Coalition of America. Now infamous, Insys Therapeutics, Inc. (Fentanyl), who currently faces multiple federal and state investigations for aggressive sales and marketing practices, donated $500,000 to Arizonans for Responsible Drug Policy, helping eke out a narrow 51-49 block of Arizona’s 2016 legalization attempt, and making it the only state in which legalization failed in 2016 voting. One of the largest individual contributions to any anti-legalization campaign in history, just five months later Insys won approval for a cannabis-derived pharmaceutical – an anti-nausea drug for AIDS patients – causing cannabis market leaders to reflect on the ethics of Big Pharma’s positioning, and why it has been favored by the DEA and FDA over plants that have already proven effective, safer, and cheaper than prescription drugs.

Stacking the Deck

Few have the resources necessary for this level of lobbying, or to manage the massive fees and extensive oversight necessary to work with the DEA and FDA for testing marijuana usage and product development – but Big Pharma does. It has achieved approval for other drugs in the past, including synthetic THC med Marinol for cancer and AIDS patients. Two cannabis-infused chewing gums by AXIM Biotech now currently await approval for IBS and MS treatment, as well as a topical for eczema/psoriasis. Kannalife Sciences is also developing new drugs for degenerative brain conditions (hepatic/chronic traumatic encephalopathy). Once approved, the drugs are classified separately from Schedule I whole plant marijuana products, their kissing cannabis cousins, and 100% legal with a script.

Are You Ready for a Changing of the Tides?

The workers compensation world is sure to experience turmoil over the upcoming years as changing legislation and front runners in the marketplace scramble for their share of the pie.

About the Author:  Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ comp insurers. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information visit http://ans-solutions.com .

Original content posted on http://ans-solutions.com/medical-marijuana-vs-big-pharma/


Wednesday, May 31, 2017

Medical Marijuana and the Workers Compensation Conundrum – Part 1


Because the U.S. Federal Government has dug-in its feet, leaving marijuana as an illegal, Schedule I drug under the Controlled Substances Act, state governments have been left to individually pave their own legalization paths, leaving a frustrated public in the wake. Employers, employees, doctors, workers comp case managers, and more feel frustratingly in-the-dark as ever-diversified, continually evolving legislation continues to change the landscape. This is the first post of our two part series of spotlighting medical marijuana in the marketplace.

What We Do Know About Medical Marijuana

Though state laws vary widely on the amount of legal possession and personal cultivation for medical use, to-date 29 states and D.C. have legalized marijuana for medical use, including 8 states who’ve legalized its use recreationally. For medicinal purposes, marijuana has been scientifically confirmed effective for pain relief, appetite stimulation, nausea control, and reducing ocular pressure. It is arguably cheaper and less addictive than opioids, however both research and quality control are lacking. For injured workers and those in the workers’ comp industry, its most-likely application is pain relief, however it’s typically not be the first drug in the treatment lineup for prescribing physicians.

What’s Murky About Medical Marijuana and Workers' Compensation

Marijuana dispensing differs from run-of-the-mill pharmaceuticals, with product obtained from dispensaries or home growth, not pharmacies, leading to a gap in patient information on potentially dangerous drug interactions. Patient protections also remain muddy. Still illegal under federal law, stateside court rulings are chaotic. Fifteen states offer little to no employee protection, while 11 states explicitly provide protections from retaliatory actions to limits on drug testing from employers. Furthermore, all states with medical marijuana have pending legislation and litigation that could have a broad impact on the workplace, creating a landscape reminiscent of the Wild West.

Who’s Paying For Medical Marijuana Prescriptions?

Who knows? Medical marijuana’s Schedule I status prohibits its inclusion in the National Drug Code, leaving Medicaid and Medicare patients on the sidelines. This lack of regulation also equates to a dearth of coding, complicating processing for pharmacy benefits managers. And state-by-state case law for prescription coverage from employer-sponsored coverage to workers’ comp, like employee protection legislation, also varies widely.

Who’s Got a Headache?

Employers. Though there is federal protection backing drug-free workplace policies, including “zero-tolerance” for specific jobs such as heavy equipment operators, pilots, and surgeons, ever-changing legislation makes it difficult for employers to figure out which end is up. In the meantime, knowledge of state-specific legislation remains key to compliance, with an attitude of managing medical marijuana like any other powerful legal prescription drug that could impair mental capacity a logical choice: Accommodate the needs of injured workers – but uphold a safe work environment, as always. ANS Solutions Medical Cost Containment Programs are the only end to end pharmaceutical cost containment programs in the industry that genuinely put the patient first, while minimizing the cost of settlement in large loss workers’ comp claims. 

ASansAbout the Author:  Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of clinical innovation and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ comp insurers. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.

Friday, May 19, 2017

Are Primary Care Physicians Leaving Opioid Deaths to Chance?

A recently released study from the Journal of Addiction Medicine has uncovered an alarming trend. Patients with opioid addiction, also referred to as opioid use disorder (OUD), experience an alarmingly high death rate – one 10 times higher than those not suffering opioid addiction. Not surprisingly, the study has raised some tough questions about the existing treatment infrastructure, and the system’s failure to identify and aid such at-risk individuals.
The Sobering StatsUsing electronic health records from a major university healthcare system from more than 2,500 patients ranging in age from 18 to 64, all identified as having an OUD, 465 deaths were observed during the eight-year period studied, 2006-2014. Drug overdose and disorder was the leading cause of death (19.8%), with deceased patients commonly experiencing other substance abuse disorders (tobacco, alcohol, cannabis, cocaine). Other causes included cardiovascular disease (17.4%), cancer (16.8%) and infectious disease (13.5%, of which 12% had hepatitis C). Alcohol abuse and hepatitis C were identified as primary markers. Compared to the general population, the deceased were more likely to be male (41.7% vs 31.6%), uninsured (87.1% vs 51.3%), and older at the time of initial OUD diagnosis (48.4 vs 39.8 years).
Unintended EffectsThough health care reforms (Federal Mental Health Parity, Addiction Equity Act, and the Affordable Care Act) were intended to lead to an expansion of services for substance abuse disorders in primary care, shifting them from previously isolated treatment centers, there appears to be a significant portion of the population slipping through the cracks. This suggests multiple issues within the current healthcare delivery system in identifying and addressing patients battling addiction:

  • Ignorance of the true risks of opioid abuse and corresponding treatments.
  • A lack of timely and sufficient screening for identifying patients with addiction.
  • Identification of addiction issues too late to provide appropriate/effective interventions.
  • A lack of addiction specialists on-site, as well a as a lack of outside resources for treatment.
The healthcare industry must find a better way to identify and treat patients suffering substance abuse disorders – before they pay the ultimate price. Clinicians in the primary healthcare setting could be a driving force – provided they receive proper training and assistance. For the worker, an effective pharmacotherapy review program ensures that recommended prescription treatment plans are necessary and appropriate and can help eliminate the potential for addiction.
This was originally posted on http://ans-solutions.com/are-primary-care-physicians-leaving-opioid-deaths-to-chance/

Monday, April 10, 2017

How Technology Is Shaping The Workers’ Compensation Industry

The technology now used within today’s workers’ comp industry is remarkable compared to what was available just a few decades prior. A dominant component of advocacy, claims, and treatment, technology is helping employers and insurers work the bugs out of the process, producing amazing results and the promise of even more unbelievable advancements on the horizon…

How is Technology Reshaping the Workers Compensation Industry?

  • Paper Falls by the Wayside
    • NOW: Endless forms and lost paperwork are no longer, replaced by automated forms, electronic signatures and correspondence that is both faster and easily trackable.
    • LATER: Lengthy, written legalese explanations will be replaced by clearer video demonstrations. Avatars, virtual assistants, and chat will become more commonplace.
  • “Smart” Tech Takes Over
    • NOW: Smartphones and mobile devices empower injured workers, offering personal claims reporting, teledoctor consultations and referrals, status and payment checks, virtual correspondence examiners/case managers, and easy access to information via chat/messaging. This faster reporting and assessment speeds treatment, lowering pain severity and costs, and boosting network penetration.
    • LATER: Wearable Tech will become increasingly common in the workplace, from high-tech safety vests and helmets to watches that identify fatigue, repetitive motions, and even alert employees of dangerous situations. For the injured, mobile self-service tools will encourage a more active role in recovery and return-to-work, and the introduction of digital wallets will offer more convenient access to prescriptions.
  • Automation Moves Things Along
    • NOW: Triggered by specific claims events, automated correspondence speeds the process with real-time text/email notifications, boosting productivity and claimant satisfaction.
    • LATER: Tech driven by “empathetic” artificial intelligence will aid claimants, further reducing workloads.
  • Video Trumps Phone Communication
    • NOW: Employers, claims professionals, nurses, and attorneys can more easily communicate remotely and interactively.
    • LATER: The transition to a more personal video telepresence will boost efficiency and improve interactions, making them more personable.
  • Analytics Provide Greater Insight
    • NOW: Predictive analysis through text mining is granting ever-faster access to previously unknown variables, identifying cost triggers (opioid use, comorbidities), and unearthing previously unidentified information.
    • LATER: Prescriptive analytics will come into play, implementing new tech that prescribes successful and actionable intervention techniques.
Exciting Times, Amazing Opportunities

The industry and employers are capitalizing on this wave of technological change. When was the last time you initiated change in your workers’ compensation medical cost containment strategy? ANS Solutions’ streamlined Pharmacotherapy Review program has a proven track record for improving efficiency, reducing costs by over 25% with a success ratio of 94%, yielding a guaranteed return-on-investment of 20-to-1 through our Guarantee Program. Centered around maximizing treatment outcomes for injured workers, our unique, multi-faceted approach delivers cost-effective, proven treatment solutions that make a lasting, positive impact on the overall employee workers’ comp experience. Blaze a new trail in this innovative era. Contact http://www.ans-solutions.com today.