FRANK LEWIS

PDT Staff Writer

A report to the Ohio Bureau of Workers’ Compensation (BWC) Board of Directors shows a newly enacted formulary has driven down the number of narcotics prescribed to injured workers by 12 percent, or 1.1 million doses, that the BWC says supports Governor John Kasich’s efforts to address Ohio’s opiate epidemic.

The 12 percent reduction in the number of doses and a 15 percent, or $2.1 million, reduction in costs shows how the reduction translates in dollars as well. The same review showed the number of skeletal muscle relaxants (SMR) prescriptions dropped by 59 percent, resulting in a 58 percent, or $532,000, decrease in cost. SMRs are among the most commonly overused drug classes and are often prescribed in conjunction with narcotics.

The report outlined how the bureau’s first ever formulary and a number of other pharmacy management initiatives are helping in efforts to increase positive outcomes for injured workers.

“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,” BWC Administrator/CEO Steve Buehrer said. “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.”

BWC began implementing its first ever formulary in September, however, BWC chose to start its study on February 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.

To curb the amount of opiates being dispensed around the state, Ohio instituted a new Emergency Room protocol in May. And it turns out the Emergency Department at Southern Ohio Medical Center has been at the forefront of the control of opiates prescribed for Emergency Department patients.

“In March of this year, we were contacted through the Ohio Hospital Association, and they shared with us the draft protocol for Ohio Emergency facilities,” said Mary Kate Dilts-Skaggs, director of Nursing for Emergency and Outpatient Services at SOMC. “And it’s really about prescribing guidelines for opiates and controlled substances.”

Dilts-Skaggs said the protocol makes a difference between acute pain and chronic pain.

“Acute is sudden onset. And chronic pain is usually people who have lived with pain for many years, like back pain,” Dilts-Skaggs said. “This information was shared with our nursing leaders and physician leadership.”

In addition to the formulary, the presentation by BWC Pharmacy Director John Hanna to the Medical Services & Safety Committee late Thursday covered several other controls BWC is placing on its pharmacy program, including:

• Point of service edits that allow BWC’s 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 said. “The added benefit is the cost savings that help us keep premiums affordable for Ohio’s businesses.”

Frank Lewis may be reached at 740-353-3101, ext. 232, or at flewis@heartlandpublications.com