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Report: BWC Pharmacy Initiative Paying Off
COLUMBUS, Ohio -- The Ohio Bureau of Workers' Compensation's first-ever formulary and a number of other pharmacy initiatives are helping in efforts to increase positive outcomes for injured workers, a new report has determined. The number of narcotics prescribed to injured workers is down by 12%, or 1.1 million doses.
"Ohio's new formulary is proving an effective way to help manage care and ensure we are getting injured workers the right prescriptions for the right conditions at the right time," said Steve Buehrer, BWC administrator/CEO. "While narcotics can be a legitimate part of the treatment process, we owe it to Ohio's workers to ensure their road to recovery doesn't descend down the dark path of addiction."
A review of prescriptions written from February to April compared to the same period in 2011 showed 1.1 million fewer prescribed doses of narcotics. This equals a 12% reduction in the number of doses and a 15%, or $2.1 million, reduction in costs, Buehrer said. The same review showed the number of skeletal muscle relaxants prescriptions dropped by 59%, resulting in a 58%, or $532,000, decrease in cost. Muscle relaxants are among the most commonly overused drug classes and are often prescribed in conjunction with narcotics.
The Bureau began implementing its first ever formulary in September; however, the Bureau chose to start its study on Feb. 1, the first day that new restrictions on opiates were implemented. The formulary is helping improve the efficiency and effectiveness of treatment, limit the inappropriate use of medications and lower prescription costs. The formulary provides a concise list of medications that can be utilized for treatment of approved conditions related to an injured worker's claim and may include guidelines related to their use.
In addition to the formulary, John Hanna, BWC pharmacy director, said the report covered several other controls BWC is placing on its pharmacy program, including:
Point of service edits that allow the pharmacy benefits manager, SXC Solutions, to screen out prescriptions that aren't related to an injured worker's condition to ensure they are receiving medications relevant to their injury.
The standardization of drug utilization reviews, a process that allows for a timely, objective evaluation of prescriptions an injured worker receives to ensure they are appropriate. Drug utilization reviews evaluate the necessity and appropriateness of prescription drug treatment and can identify overuse or dangers mixing of prescriptions.
A pharmacy lock-in program that was established to limit the practice of doctor and pharmacy shopping, and the dangers that can arise when medications are prescribed by multiple physicians and are processed in different pharmacies. The program allows BWC, under certain circumstances, to require an injured worker to use a single pharmacy for non-emergent prescriptions. BWC can also restrict an injured worker convicted of a drug offense to the use of a single prescribing physician in order to receive reimbursement for non-emergent prescriptions.
Requiring generic medications when available.
"By better understanding and managing the role of pharmaceuticals in recovery, we are helping injured workers heal and get back on the job sooner," Buehrer noted. "The added benefit is the cost savings that help us keep premiums affordable for Ohio's businesses."
Published by The Business Journal, Youngstown, Ohio.