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MedImpact Reduces Opioid Overutilization by 36 Percent

November 8, 2017

MedImpact Reduces Opioid Overutilization by 36 Percent Program Helps Manage Appropriate Access to Opioids

SAN DIEGO, November 8, 2017- MedImpact has released a three-year case study showcasing the impact of clinical intervention in reducing opioid use. Through the MedImpact Overutilization and Safety Controls Program, MedImpact limited potential opioid overuse and reduced opioid overutilization by 36 percent. The opioid coordinated care case study proves results, driven for plan sponsors through a partnership with MedImpact.

The case study (link) focused on the results of a program from April 2013 to October 2016 to better manage opioid prescription use. During the three-year study, MedImpact identified more than 600 patients filling opioid prescriptions in excess of evidence-based guidelines. MedImpact conducted clinical interventions with prescribers that led to a 36-percent reduction of overutilization, saving plan sponsors unnecessary spending and providing better care for patients.

“Plan sponsors have been searching for an effective solution to the opioid epidemic,” states Virginia Howe, MedImpact Senior Vice President of Health Services. “We are confident that this program helps in the effort to reduce adverse events and unnecessary spending resulting from opioid abuse, as evidenced by our reduction in overutilization.”

MedImpact created the Overutilization and Safety Controls Program, an advanced retrospective intervention that reviews incoming pharmacy claims for a member’s Morphine Equivalent Dose (MED) per day that is equal to or exceeds a predetermined threshold across single or multiple opioid claims. Starting April 2013, MedImpact performed monthly claims analysis to identify members with a cumulative daily MED exceeding 120 mg for at least 90 consecutive days. It also flagged patients with three or more prescribers and three or more pharmacies over a consecutive 90-day period.  MedImpact mailed intervention materials monthly to providers prescribing the highest volume of opioids to verify  appropriateness of use of opioids.

The Overutilization and Safety Controls Program (link) details MedImpact’s success in mitigating opioid overutilization, and provides the detailed methods and results that provided cost savings and better care. Download the case study here.


About MedImpact

MedImpact, an independent, trend-focused PBM™, is the nation’s largest privately held PBM, serving health plans, self-funded employers and government entities. Our business model is unique. We focus on effectively managing client pharmacy benefits to promote Lower Cost and Better Care through One Source. Our model aligns us with our clients. We help promote prescribing of lower-net-cost, medically appropriate drugs with fulfillment at the most appropriate participating pharmacy providing competitive pricing, good value and high-quality service. Our number-one goal is client satisfaction by providing flexible solutions and member-centric products with a focus on lowest-net cost and quality outcomes.


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