State governments are responding to the opioid epidemic. Recently, the New Jersey governor signed new legislation that limits prescribers’ capacity to provide first-time opioid prescriptions for more than five days. The New Jersey state senate passed a law that went in effect earlier this month also requiring prescribers to document patient education regarding the risks of opioids and pain management plans and evaluate opioid prescriptions quarterly. And last year, the Arizona governor signed a law that required Arizona state-funded programs to limit first-fill opioid medication prescriptions to a 7-day supply in order to curb future drug addiction.
But governmental response is slow and often uneven. Businesses move faster, which is why it is critically important for payers of workers’ compensation benefits to provide resources for provider and patient education, limitations and oversight for comprehensive drug safety. The two key mechanisms for limitation: point-of-sale checkpoints and long-term prescription care intervention.
Point of sale
Responsible payers should have systematic checks and balances in place to identify and refer non-formulary prescriptions for clinician oversight and intervention. Items such as high-dose opioids, compound medications and high-risk drug classes should also be included for referral to a specially trained pharmacy clinician with the skills to identify problematic situations and discuss alternative care.
Payers should have arrangements with pharmacy networks in order to identify patients at risk for addiction or unintentional overdose. A team of uniquely trained nurses and doctors must be available to intervene when pharmacy data points to an at-risk situation. It is critical that payers hold patients and providers accountable for safe prescribing and responsible care. Truly connect with the pharmacy benefit management network. Enable automated indicators to identify problematic prescriptions and prescribers who practice outside the guidelines.
Our nation is in the midst of a drug epidemic. Lawmakers are responding, but the wheels of legislation move slowly. Lives are in the balance. Payers must be diligent in making sure that America’s workers are protected from dangerous drugs, prescribers and drug combinations. The right formula is to have systematic identification of dangerous scenarios and reliable, skilled follow up for rapid interventions and education.
Reema Hammoud, PharmD, BCPS, Director, Clinical Pharmacy