BWC: Prescription Formulary Changes Save $20M
COLUMBUS, Ohio -- Changes made to the Ohio Bureau of Workers' Compensation's pharmacy management program have resulted in a total drug cost savings of more than $20 million since 2012, reports the administrator of the BWC, SteveBuehrer. The changes include a reduction in prescriptions of some of the most commonly overused drugs.
"While prescription narcotics can be a legitimate part of treatment, we have a duty to protect injured workers and their households from potential abuse by ensuring narcotics are properly prescribed and monitored," Buehrer told his , board of directors. "By prescribing only the right medicine at the right time and for the right duration, we are improving care, getting the worker healed and back on the job sooner, and ensuring that medicine cabinets aren't stocked with potentially dangerous drugs that could lead to overdose or addiction."
Opiate doses have dropped by 10.9 million since 2010, before the introduction of BWC's inaugural outpatient medication formulary in 2011, he said. The changes also resulted in a 27.8% drop in opioid prescriptions and a 72.9% decrease in skeletal muscle relaxant prescriptions in 2013 compared to 2010.
The formulary is updated regularly and includes guidelines for coverage of various drugs. For example, a 2012 update restricted most skeletal muscle relaxants to coverage for 90 days from the first prescription, plus one additional 30-day prescription per 12-month period. Some restrictions put into place for opioid and anti-ulcer agents require prior authorization or a related condition approved in the claim, Buehrer noted.
The announcement comes on the heels of a new rule requiring medical providers caring for chronically injured workers to use the Ohio Automated Rx (prescription) Reporting System. BWC's newest pharmacy rule, similar to recently adopted statewide Opioid Prescribing Guidelines, became effective Jan 1. Ohio providers who write controlled substance prescriptions for chronic care must now enroll in the system for BWC to cover them. Chronic care is defined as when providers write three or more prescriptions for controlled substances for the same injured worker during a 12-week period.
Other pharmacy program controls BWC implemented to support prescription drug safety for injured workers are:
- A lock-in program that limits the practice of doctor and pharmacy shopping.
- Standardized drug use reviews intended to objectively evaluate the need and appropriateness of prescription drug treatment and identify overuse or danger.
- Generic medications are required when available.
Published by The Business Journal, Youngstown, Ohio.
CLICK HERE to subscribe to our twice-monthly print edition and to our free daily email headlines.