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Workers' Comp

Changes to the ODG Drug Formulary Impact Opioid Class

December 7, 2022
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Effective December 2, 2022, the Official Disability Guidelines (ODG) Drug Formulary updated the opioid drug class.

The following drugs moved from Y to N status:

  • Codeine
  • Hydrocodone/acetaminophen
  • Hydromorphone
  • Morphine
  • Oxycodone
  • Oxycodone/acetaminophen
  • Tramadol (IR and ER)
  • Tramadol/acetaminophen

These medications will require a prior authorization (PA) to process at the pharmacy if the injury jurisdiction utilizes the ODG formulary. These injury jurisdictions are Arizona, Indiana, Kentucky, Montana, Oklahoma, Tennessee and Texas.

The following medications are now Y status:

  • Kloxxado (naloxone nasal 8mg per actuation)
  • Zimhi (naloxone injection 5mg per 0.5ml)
  • Naltrexone 50mg

Except for some injury specific formularies, these medications will not require a PA to process at the pharmacy if the injury jurisdiction utilizes the ODG formulary as stated above.

If you have any questions about this update, please contact your account manager or client services manager.