Curbing the Opioid Epidemic

Opioid Strategies Net $20 Million in Savings

Changes implemented in Ohio over the last two years are successfully reducing opioid prescribing.
By: | March 7, 2014

Ohio’s workers’ comp system has seen its total drug costs decrease by more than $20 million in the last two years, according to state officials. The finding was included in the latest update on the Bureau of Workers’ Compensation’s pharmacy program.

Pharmacy officials credit the savings to a variety of changes in recent years, including the establishment of a closed formulary. The BWC also stopped covering prescriptions from decertified prescribers, eliminated coverage of repackaged drugs, mandated compliance with U.S. Pharmacopeial Convention guidelines, and required all prescriptions in medical only claims to have prior authorization, among other changes.

The savings came despite increases in the cost of the average prescription and drug cost per injured worker. In addition, the system saw its opiate costs decrease by nearly $18 million.

The BWC also reported the following impacts on opioid prescriptions from the formulary changes:

  • Injured workers receiving opiates decreased by 22.5 percent.
  • Opiate prescriptions decreased by 27.8 percent.
  • Opiate prescriptions per injured worker decreased by 6.8 percent.
  • Opiate doses decreased by 26.2 percent.
  • Opiate doses per injured worker decreased by 4.8 percent.

Since 2010, BWC has experienced a reduction of 10.9 million opiate doses, the officials said.

The news comes just after the BWC instituted a rule in January requiring medical providers who write three or more controlled substance prescriptions for the same injured worker during a 12-week period to use the Ohio Automated Rx Reporting System drug database, or OARRS.

Going forward, the BWC said it will continue to manage drug utilization through formulary and relatedness list updates, manage the transition of the drug utilization review process to the managed care organizations, develop an automated process to identify high-risk medication regimens and trigger direct clinical staff contact with the prescriber, and implement a retail pharmacy-based medication therapy management program.

Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected].

More from Risk & Insurance