Prescribe no more than needed, Greater than a 7 day supply of the first opioid is rarely warranted

Impact of CDC Guidelines in Workers’ Comp 1

For the population receiving their first opioid prescription prior to the CDC Opioid Guidelines release, there was a fairly even distribution of days supply among the less than three (<3) days supply, 3-7 days supply, and those receiving greater than seven (>7) days supply. It is concerning that prior to the CDC Opioid Guidelines release, 32% of claimants received greater than a 7 days supply for their first opioid prescription.

The results showed improvement in the percentage of claimants receiving greater than seven (>7) days supply, a reduction from 32% to 23%. However, there was a reduction in the percentage of claimants receiving less than three (<3) days supply from 32% to 17%. The reduction of the <3 and >7 groups appear to have shifted to the 3-7 days supply groups, an increase from 36% to 60%. Even taking these shifts in days supply into account, 23% of claimants are receiving an initial opioid prescription with a days supply greater than seven days, rarely necessary according to the CDC.

It is of interest to note that upon further analysis, OxyContin appeared as number 10 of the top 10 drugs written for greater than seven days supply as the first opioid prescription in the population of claimants prior to the CDC Opioid Guidelines’ publication. In this population, OxyContin comprised 0.6% of the prescriptions written for greater than 7 days supply. Only short acting opioids appeared in the top 10 drugs prescribed after the guidelines were published.

Discussion of Results

This study was intended to be an evaluation of the workers’ compensation industry as it relates to CDC Opioid Guidelines compliance prior to and after the publication of the CDC Opioid Guidelines.

The influence of numerous other factors on the prescribing habits of prescribers could not be accounted for in this study. Insurers, PBMs, and managed care organizations have continued to make gains in opioid intervention.

Quantification of how industry specific guidelines and state regulations have impacted prescribing habits also cannot be accounted for in this study. Regardless of the relatively positive changes seen since publication of the CDC Opioid Guidelines, a very significant percentage of claimants continue to be subjected to high risk opioid prescribing.



Posted in: Case Studies & White Papers, Workers' Compensation Management, Pharmacy Solutions

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