Prescription narcotic overdoses cause more deaths than cocaine and heroin combined each year. Misuse and abuse of these powerful medications also result in significant extra expense for workers’ compensation payers. St. Louis-based Express Scripts announced the launch of its Morphine Equivalent Dose (MED) Management program, which allows payers to better manage narcotic use among injured workers, reducing abuse and controlling costs.
“Narcotics make up a third of the cost and utilization of all workers’ compensation prescriptions. These are potent medications that have a very high risk of addiction, and the health and financial costs of abuse are incredibly high,” said Tim Pokorney, clinical director, Workers’ Compensation, at Express Scripts. “Our MED Management program is the industry’s first proactive solution that is completely customizable to a payer’s needs.”
Narcotics can be an important part of the treatment for pain in work-related injuries. Express Scripts’ MED Management program for workers’ compensation payers helps ensure clinically appropriate use of narcotics to promote safety and improve treatment outcomes.
“Our goal with this program is to enable payers to proactively manage narcotic utilization while ensuring that injured workers have access to the medication they need,” Pokorney said.
Express Scripts’ MED Management program enables payers to establish maximum threshold levels for the amount of narcotic medications an injured worker is prescribed. Amounts exceeding this level undergo a review process before the medication is dispensed, providing payers greater opportunity to ensure appropriate use of narcotics.
Patricia Brookey, vice president of Managed Care Services, PMA Companies, says she is very pleased to see this innovative solution from Express Scripts.
“Narcotic utilization, and the potential for these medications to cause dependence, is a big concern for us as a workers’ compensation specialist,” she says. “We are focused on controlling pharmacy costs for our clients and improving injured worker outcomes. Express Scripts’ new product is one of the first proactive utilization management programs available for narcotics. The addition of the Morphine Equivalent Dose program to PMA’s portfolio of managed care solutions will help us achieve even better results for our clients.”
The Express Scripts MED Management program is customizable for payers’ specific populations. Payers can set maximum threshold levels for individual prescriptions as well as for the total amount of narcotics in the overall treatment regimen based on existing research, published literature and clinical guidelines. Client-specific claims analysis also is available to help payers determine the appropriate MED threshold.
This is the only point-of-sale MED Management program in the industry that enables proactive safety checks to ensure appropriate narcotic utilization.
Source: Express Scripts
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