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Combating Opioid Waste and Abuse

Opioids are now the leading cause of accidental death in the U.S. According to the Center for Disease Control (CDC), there were a total of 47,055 lethal drug overdoses from opioids in 2014. Despite this startling statistic, prescribers wrote nearly a quarter of a billion opioid prescriptions in 2013—enough for every American adult to have their own bottle of pills. Today, the CDC estimates 4.5 million Americans are addicted to opioid prescription drugs.

There are many reasons for such high rates of prescription opioid addiction. In a 2015 study conducted by the Mayo Clinic, one in four people who had been prescribed opioids progressed to longer-term prescriptions, increasing chances of addiction. Other studies concluded that another main cause of opioid abuse is prescribing for patients who receive the drugs for short-term pain relief, but receive many more doses than needed.

To reverse this epidemic, we need to address prescription opioid addiction at its roots. Prescribers, pharmacies, health plans, and pharmacy benefit managers all have a part to play in the prevention of opioid abuse and reducing unnecessary prescribing and dispensing.

In recent years, there has been good news.  IMS Health reports that U.S. opioid use has declined for the first time in 20 years, 12 percent fewer prescriptions nationally since it peaked in 2012. This decrease may be due to increased monitoring of the problems described above, including the use of prescription drug monitoring programs.

Fighting Opioid Abuse Together

To combat opioid waste and abuse, MedImpact offers the Opioid Cumulative Dosing Program, a CMS-compliant prescription drug monitoring program. The program uses an individual member’s existing prescription data from prescribers, pharmacies and health plans regarding opioid utilization to create a larger view of the patient’s medication use and needs.

In addition to helping stop high-dose individual prescriptions, the program identifies the total amount of opioid prescriptions a member may be taking, along with the number of pharmacies or prescribers a member may be utilizing. 

This cumulative dosing limit increases patient safety and bridges the gap in knowledge from one pharmacy or prescriber to another to reduce potential fraud, waste and abuse from those who may be “shopping" at different locations for prescriptions.

In addition to these edits, the program also creates a list of the top 2 percent of opioid prescribers, further limiting the potential for poor practices.

As research continues, we will continue to develop and implement programs to help prevent opioid abuse and unnecessary utilization and limit fraud, waste and abuse.

For More Information

As always, we keep clients informed about combating opioid abuse and its potential financial impact. We are constantly evolving innovative programs designed to drive low-net cost while meeting plan sponsor, prescriber and member needs. Please contact your account representative for more information on how we can assist you in managing opioid use and preventing addiction. If you don’t have an account, email us at info@medimpact.com

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