PBM Tools Offering
OPIOID PROGRAM
REDUCE ADDICTIONS AND OVERDOSES
The overuse and misuse of prescription opioids is well documented in clinical journals and mainstream media. The manufacturers of these products have paid out billions of dollars in lawsuits because of their negligent marketing of these products. Payers have been unwitting participants in this problem by covering these medications as prescribed by physicians but often outside of approved standards of care.
The Opioid Program targets overuse of this very addictive and potentially dangerous class of medications. These medications are often used inappropriately for chronic pain, exposing patients to increased risk of addiction and overdose.
The program works by limiting opioid prescriptions to a seven-day supply unless the patient has a diagnosis of terminal cancer or support documentation from the provider exists. This process forces the prescriber and the patient to continually evaluate therapy and hopefully identify alternative pain management therapies.
There are many benefits for both the patient and the plan sponsor. The program reduces the incidence of addiction to opioids and overdoses of the drugs while also reducing the plan liability from adverse events.
