Opioid Drug Prescriptions Declining in Texas Work Comp System

Texas Commissioner of Workers’ Compensation Rod Bordelon told the Texas House Committee on Public Health that the number and cost of opioid drug prescriptions in the Texas workers’ compensation system has declined.

Testifying before the committee on April 7, Bordelon said the adoption of new pharmacy rules has produced positive results.

Since the Division of Workers’ Compensation (DWC) implemented a closed pharmacy formulary for the treatment of injured employees, Bordelon told Committee Chairwoman Lois Kolkhorst and committee members, the number of “not-recommended” or “N-drug” prescriptions have declined 74 percent and the cost of those prescriptions has dropped 82 percent from 2010 to 2011.

Opioid drug prescriptions have fallen 10 percent since the implementation of the formulary. The closed pharmacy formulary took effect for new workers’ compensation claims on Sept. 1, 2011, and for older claims on Sept. 1, 2013.

“There is no disputing the growing concern over the abuse of prescription drugs, particularly opioids,” Bordelon said. “It’s a serious issue in health care, including workers’ compensation.

“We are seeing significant downward trends in opioid drug prescriptions in the treatment of injured employees in Texas,” he said. “The new closed formulary, along with evidence-based treatment guidelines, utilization reviews and enforcement efforts, has helped combat overutilization of unnecessary drugs in Texas, while safeguarding medically necessary care that promotes an injured employee’s ability to return to work quickly and safely.”

The closed formulary includes all FDA-approved drugs, except for investigational and experimental drugs and excludes drugs listed as “not recommended” in Appendix A of DWC’s adopted treatment guidelines.

Under the formulary, prescriptions for “N drugs” must be preauthorized by the insurance carrier before being dispensed to an injured employee.

The Committee on Public Health was asked by Texas House Speaker Joe Straus to “assess the prevalence of nonmedical prescription drug use in the state (including opioid analgesics, stimulants, tranquilizers, and sedatives) and address adverse health impacts.”

Source: Texas Department of Insurance – Division of Workers’ Compensation