Insurer’s Opioid Program Shows Promise in Curbing Prescription Painkiller Addiction

Nationwide there has been an increase in the number of opioid pain medications prescribed to workers who are injured on the job. EMPLOYERS, has completed the pilot test of a program to prevent the abuse of prescription opioid drugs. The company says the program has dramatically reduced the amount of medically unnecessary opioids prescribed and the time it takes to wean injured workers from them, once prescribed. It has also resulted in millions of dollars of cost savings over the past 18 months. Due to its success, the company is rolling it out on a broader scale.

“The Centers for Disease Control has reported that more people are dying from prescription painkillers than from heroin or cocaine,” said Stephen V. Festa, executive vice president and chief operating officer at EMPLOYERS. “Opioid addiction decreases worker productivity, makes workplaces less safe, prolongs disability claims, and increases the risk of death from overdoses.”

The opioid program takes proactive measures to help control the flow of narcotics within the workers’ compensation claim. Its approach involves the workers’ compensation insurance carrier, injured employees, workers’ compensation physicians and pharmacy benefit managers.

“We realized that the best way to address this growing problem is to involve everyone connected to it,” Festa said.

The first prong of the program focuses on training physicians to recognize the signs of opioid abuse and encourages them to consider other effective pain management alternatives.

“In a lot of cases, less addictive alternatives could be more appropriate and just as effective,” Festa said.

Working in collaboration with pharmacy benefit managers, among others, EMPLOYERS has created an information exchange network for workers’ compensation physicians. Through this network, doctors can engage in peer-to-peer discussions with other doctors to share ideas about safer, medically appropriate pain management plans in addition to strategies to wean injured employees off of opioid painkillers.

“Doctors are receptive to feedback and advice from other doctors,” Festa said. “They just don’t always have access to it in the workers’ compensation arena. By facilitating that access, we’re helping both doctors and their workers’ compensation patients.”

The second component of the opioid program is to promote those network physicians who successfully return injured workers to their jobs without over-prescribing of opioid pain medications. While injured workers are free to choose any doctor in the extensive medical provider network, EMPLOYERS will suggest that injured workers consult with the doctors whose patients have a much lower incidence of opioid addiction issues.

The third part of the program involves stepped-up drug testing procedures that enable earlier detection of potential drug abuse and drug diversion. The drug tests are designed to ensure all prescribed narcotics, and nothing else, appear in the patient’s system. Drug tests are cross-referenced with the patient’s type of injury to ensure painkiller prescriptions remain within recommended protocols for that injury.

“Drug tests provide good indications of patients who are seeking prescriptions from multiple doctors or whether drug diversion is taking place. With that information available to the physician, pharmacy benefit manager and insurance carrier, those three parties can work as a team to figure out the appropriate treatment for the injured worker,” Festa said.

EMPLOYERS said it continues to expand its focus on medication management by educating physicians about the most up-to-date, evidence-based medical protocols; educating injured employees about the dangers of opioid over-utilization; and working with pharmacy benefit managers and peer review partners to coordinate efforts to promote safe use of opioid prescription drug therapy.

Source: EMPLOYERS