2017 NWCDC

Physician Education Mitigates Rx Risks

Workers' comp providers can work with doctors, adjusters and patients to get a handle on pain prescriptions.
By: | December 7, 2017

As medical costs keep rising and the opioid crisis continues, workers’ compensation providers can influence prescriber behavior to not only control costs but also improve quality of care.

Physician dispensing remains a top challenge. Workers’ comp drugs can be as much as 50 to 1,000 percent more expensive than if dispensed in retail pharmacy. Doctors have financial incentives to dispense from their office, but doing so removes the extra layer of oversight provided by pharmacies, presenting a safety risk to patients.

“We can’t expect adjusters to have the clinical knowledge that doctors and pharmacists spend years developing.” Britten Featherston, PharmD, clinical pharmacist, Healthesystems

According to Jean Feldman, director of managed care for Sentry Insurance and presenter at a Dec. 6 session at the National Workers’ Compensation and Disability Conference & Expo in Las Vegas on pharmacy management strategies, “Doctors often have no idea what the back end cost is when they dispense medications from their office. We need to bring it to their attention.”

Jean Feldman, director of managed care, Sentry Insurance

Similarly, workers’ comp professionals can educate adjusters who are involved in making clinical decisions despite having no or little clinical training.

“We can’t expect adjusters to have the clinical knowledge that doctors and pharmacists spend years developing,” said co-presenter Britten Featherston, PharmD, clinical pharmacist with Healthesystems.

State and federal bodies are making steps in the right direction. CDC opioid guidelines issued in 2016 directly address physicians in an attempt to set best practices.

More states are mandating that doctors check prescription drug monitoring programs before writing a script. California is set to launch a formulary on Jan. 1, 2018, which could provide a model for other states looking to implement their own.

Communication among physicians, adjusters, insurers, pharmacists — and most importantly, patients — is critical to prevent unnecessary pain management prescriptions and to mitigate the risk of side effects and/or interactions between multiple medications.

Katie Dwyer is a freelance editor and writer based out of Philadelphia. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Matrix: Presented by Liberty Mutual Insurance

11 Crucial Trends That Are Impacting the Construction Industry Today

Increased hurricanes, opioids, women workers and more are just some of the latest trends driving construction risk.
By: | November 1, 2019




The R&I Editorial Team can be reached at [email protected]