Opioids, ACOEM’s new guidelines, compounds, and, alas, physician dispensing.
Here’s a quick guide to the top issues and sources for additional info.
Opioids continue to plague the industry; while many PBMs and payers are having some success in reducing the use of opioids in new claims, there’s still a huge group of legacy claimants that have been on far too many pills for far too long. Sandy Blunt and I conducted a survey on the opioid issue last fall (thanks to CID for sponsoring and the 400 participants for their insights) – The Survey of Opioid Management in Workers’ Comp can be downloaded here.
Last reminder – make sure you are going to Operation UNITE’s Prescription Rx Summit in Atlanta April 22 – 24. The Summit is focused on all aspects of the prescription drug abuse problem.
Perhaps the best new tool in our armamentarium comes from ACOEM – their opioid guidelines were released last month and are available to subscribers here. (you can also get a 14-day trial subscription). A trio of highlights that challenge conventional wisdom merit attention:
- No comparative trial shows that an opioid is superior to another medication (out of 28 trials.)
- No evidence shows the long-term efficacy of opioids – the longest placebo controlled trial lasted only 4 months
- 80-94% of opioid trials have industry conflicts (funding and/or conflicts of interest in the trials).
I’ll be posting an in-depth review of these guidelines later this week. For now, my non-clinicians take is these are the best opioid guidelines out there; very well researched, highly credible, and desperately needed.
Express Scripts published a report on their work comp results; you can get a summary here. (hat tip to WorkCompWire)
CompPharma, the consortium of work comp pharmacy benefit managers (of which I am president), released a research paper on compounding medications in work comp; you can get a copy here (no cost, and no registration required)
I don’t see medical marijuana as a big issue; If anything it will be of occasional interest. That said, in our upcoming Survey of Prescription Drug Management in Work Comp, we will be asking payers what their view of the issue is, and will report back on the results. Participants (previous reports can be found here).
Finally, we’d love to have you participate in the Prescription Drug Management in Work Comp survey; participants receive a MUCH more detailed copy of the report than regular people which includes a wealth of data points and statistics. e-mail me at infoAT healthstrategyassocDOTcom (replace the caps with symbols first!) and we’ll sign you up (all responses are confidential and no company-specific data is shared).