Texas: Closed formulary results in fewer opioid scripts in WC
"Texas is now leading the charge in combating overutilization of unnecessary prescription drugs in the workers' compensation system," said Rod Bordelon, the state's workers' comp commissioner, after the preliminary results of a study of changes in the system.
Texas adopted a pharmacy closed formulary in September 2011. It contains a list of "not recommended" -- or N -- drugs that require preapproval from the insurance carrier before they are dispensed. The Texas Division of Workers' Compensation updates the list of N drugs monthly based on information from the Official Disability Guidelines
-- Treatment in Workers' Comp.
The closed pharmacy formulary takes effect for older claims with dates of injury prior to September 2011 on September 1, 2013.
The adoption of the pharmacy closed formulary has resulted in fewer opioids, narcotics, and other not recommended drugs being prescribed, according to the DWC. In a study comparing injuries that occurred between September and November 2011 with those that occurred during the same period in 2010, the DWC found the following:
- Claims receiving N drugs were reduced by 54 percent. The frequency of N drug prescriptions being dispensed to injured workers was reduced by 65 percent.
- Costs attributed to N drugs for 2011 claims were reduced by 75 percent, approximately $841,000.
- Total prescription drug costs for 2011 decreased by 26 percent, approximately $1.4 million.
- The frequency of opioid prescriptions dispensed to injured workers decreased by 10 percent, and the costs associated with opioid prescriptions decreased by 17 percent.
"This is significant," Bordelon said. In addition to the formulary, he credited treatment guidelines, preauthorization requirements, and enforcement efforts for the changes.
Read more at the WorkersComp Forum homepage.
July 26, 2012
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