Paduda: Chronic Opioids Can Be Solved

Friday, October 12, 2018 | 0

That’s the key lesson from Oct. 3's session on dealing with legacy opioid claims at International Association of Industrial Accident Boards and Commissions' 104th convention in Virginia.

Joe Paduda

Ohio Bureau of Workers' Compensation's pharmacy director Nick Trego, State Fund of California’s Chief Medical Officer Dinesh Govindarao, Washington State Department of Labor and Industries' Medical Director Gary Franklin, and Sedgwick pharmacy director Paul Peak all documented significant reductions in long-term opioid usage in their patient populations.

That means many fewer moms without kids, husbands without wives, and kids without grandparents.

Among the takeaways:

• Prevention is critical. We’re doing a very good job of preventing more opioid abuse disorder (OAD) patients.
• Flexible treatment options are critical. Every patient is different, with some responding to medication-assisted therapy, and others not. The same is true for exercise, yoga, cognitive behavioral therapy, acupuncture and physical therapy.
• Closed physician networks, formularies and utilization review with teeth are critical. It’s tough to get bad docs to become good ones, so kicking them out of your panel is necessary.
• Analytics are critical. To identify patients at risk of OAD, to monitor progress, to evaluate success, to learn what works, what doesn’t and why.
• Full payer access to prescription drug monitoring programs is critical, but only available in a handful of states. Access to PDMPs that require physician usage would go a long way toward reducing inappropriate prescribing and polypharmacy.
• Results. Across the board we heard of dramatic reductions in the volume and potency of scripts prescribed ,and the number of patients taking opioids over the long term.

What does this mean for you?

It can be done, it is being done and it must be done.

Joe Paduda is co-owner of CompPharma, a consortium of pharmacy benefit managers. This column is republished with his permission from his Managed Care Matters blog.