October is National Substance Abuse Prevention Month. In recognition of this observance, this article explores how plan sponsors and their PBM can play an important role in addressing one of the most persistent public health challenges — the opioid crisis.
While recent research indicates a decrease in opioid misuse and overdose deaths in the last few years1, the opioid crisis remains a pressing concern for employers, affecting workforce health, productivity, and healthcare costs.2 Plan sponsors are looking for strategies to promote safe medication use, support affected employees, and control associated costs – Pharmacy Benefit Managers (PBMs) like Benecard Services can be a critical ally in the fight against prescription drug abuse.
The Role of PBMs in Managing Opioid Use
PBMs serve as intermediaries between employers, healthcare providers, pharmacies, and patients, ensuring the prescription medications are used safely and appropriately. Below are a few strategies that help identify and prevent misuse before it leads to dependency and higher medical costs:
Clinical Program Implementation
Clinical programs can be implemented to ensure safe and appropriate utilization of medications, including clinical reviews to flag and address unsafe prescribing practices. For example, Benecard implemented a Starter Dose Program, a clinical safety initiative that limits initial opioid prescriptions to the smallest effective quantity. This approach allows members to obtain their opioid prescriptions safely to reduce the risk of addiction and helps control related costs.
Utilization Controls
An effective opioid management strategy requires sophisticated oversight mechanisms such as drug quantity limits, single-pharmacy dispensing restrictions, and prior authorization. These tools help prevent doctor shopping and inappropriate prescribing.
A Collaborative Approach
The opioid epidemic requires coordination among multiple stakeholders, including health care providers, pharmacies, drug manufacturers, and employers. PBMs like Benecard Services serve as the crucial connector between these parties, facilitating this collaboration and ensuring that clinical protocols, data sharing, and benefit designs align with employer objectives and employee well-being.
As the opioid crisis continues to impact American workplaces, employers need strategic partners who prioritize clinical vigilance, data transparency, and member safety. With its comprehensive approach to opioid management, Benecard Services can help employers address this critical public health challenge while maintaining the prescription drug coverage their employees need for legitimate medical conditions.
References & Resources:
1. https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html#:~:text=Opioid%2Dinvolved%20overdose%20deaths1,involved%20opioids%20(about%2076%25).
2. https://www.brookings.edu/articles/the-economic-impact-of-the-opioid-epidemic/