The U.S. Food and Drug Administration (FDA) has acknowledged that prescription drug overdoses are now the leading cause of injury-related deaths in America, surpassing auto accidents. More trouble is on the way with Zohydro ER, the first pure opiate painkiller. It received approval last October. A pure hydrocodone pill, Zohydro is five to 10 times more potent than currently available products such as Vicodin or Lortab. Zohydro ER will not contain any abuse-deterrent properties, which is expected to allow addicts to more easily crush, snort, and inject the powerful drug.
More than half the states’ attorney generals have asked the FDA to withdraw approval of the drug. The FDA Commissioner told the Senate that the drug is a safe and effective option for patients with excruciating pain. While some carriers will not have to pay for Zohydro ER due to drug formularies, we are sure to see the effects in the WC populous. Abuse is certainly a concern. How about increasing drug tolerance levels?
So what does this mean for carriers, case managers, and providers? The playing field is wide open for abuse and addiction as no one seems to be tending the gate. Carriers and case managers have to be the gate keepers. Be aware of what is being prescribed by not only the providers working your claim but by PCP’s, hospitals, and other clinics. Medication reconciliation is the big focus in healthcare and is helping to reduce issues with abuse, poly-pharmacy issues, and duplication. Another tool is by enforcing your states regulations on use of formulary drugs.
Case management offers carriers opportunities to manage and reduce risk as well as the cost of the claim. As a case manager, medication reconciliation is a big part of an initial interview. This is where the red flags are identified. Actions can be taken to avoid claims falling into the high risk category and reduce the incidence of abuse and addiction by providing education, support, and guidance.
The New York Times – New Painkiller Rekindles Addiction Concerns, Roni Caryn Rabin
Genex – State Watch