Managing the pain of prescription drug cost: Defining the solutions

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Kimberly George, Sedgwick

Kimberly George, Sedgwick

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  • 1. Sedgwick © 2013 Confidential – Do not disclose or distribute. Managing the pain of prescription drug costs: Defining the solutions http://blog.sedgwick.com/2013/05/21/managing-the-pain-of-prescription-drug-costs-defining-the-solutions/
  • 2. Sedgwick © 2013 Confidential – Do not disclose or distribute. 2 Today medication prices are rising faster than any other medical expenditure Overview • Powerful narcotics and opioids are fueling these expenditures • These narcotics are becoming more commonly prescribed in response to work-related injuries.
  • 3. Sedgwick © 2013 Confidential – Do not disclose or distribute. 3 Defining the Solutions Creation and use of an effective workers’ compensation formulary Ensuring claims examiners and nurse case managers receive notification based on select triggers. Review the injured worker’s complete medical history, using both in network and out of network transactions Utilize close monitoring when narcotics or opioids are prescribed
  • 4. Sedgwick © 2013 Confidential – Do not disclose or distribute. 4 Defining the Solutions Require follow up appointments within three days and only authorize three days of initial treatment Educate and inform employees of the benefits, dangers, and alternatives for narcotics and opioids Use of a comprehensive and focused network of pharmacies and prescribing providers Rely on advanced technology systems
  • 5. Sedgwick © 2013 Confidential – Do not disclose or distribute. 5 Defining the Scope Many of these medications were not originally intended to treat occupational injuries. Little evidence to support benefits of their long-term or widespread use in the workers’ compensation arena. High risk for abuse
  • 6. Sedgwick © 2013 Confidential – Do not disclose or distribute. 6 Follow up appointments Employee education Pharmacy clinical reviews Strong network of pharmacies Prescribing providers Technology Strategies and Solutions
  • 7. Sedgwick © 2012 Confidential– Do not disclose or distribute. 7 Kimberly George SVP, Managed Care Practices and Client Services Kimberly.George@sedgwick.com http://blog.sedgwick.com/