pharmacotherapy review Prescription drug abuse is a nationwide epidemic with the Workers’ Compensation industry experiencing significant collateral damage. The trending use of opioid analgesics for chronic pain treatment of injured workers, coupled with the high potential for dependency or abuse of opioids not only contributes to skyrocketing costs for the payer, but also poses increased risks for the injured worker. So where can Payers turn to break the pharmaceutical cost cycle?

A Drug Utilization Review That Actually Works

Many pharmaceutical cost containment strategies incorporate a drug utilization review program as a means for managing large claim pharmaceutical costs and injured worker outcomes. But not all drug utilization review programs are created equal. Often these “drug evaluations” yield sub-optimal analyses that neglect to take into account patient and prescriber history, co-morbidities, and other important factors. All too often these programs fail to provide actionable treatment recommendations, let alone reductions in cost. To realize optimal outcomes, Workers Compensation payers need to go a step further with a cost containment strategy that employs a truly comprehensive Pharmacotherapy Review Program.

With Collaboration Comes Results

Real results come from a pharma review process built around an intimate, end to end collaboration of stakeholders, with a shared focus on producing the very best outcomes possible. A nurse expert in pharmacology reviews the medical information of the injured worker to assess the existing treatment regimen based on best available medical evidence. This expert review is used to develop clinically appropriate recommendations which are proposed face-to-face to the treating doctor. The end result is a signed-agreement for a new treatment plan, typically one that curtails costly pharma regimes. The nurse expert and treating physician will continue to collaborate to implement the recommended treatment plan. This is specifically the case when dosing modifications or weaning of certain medications is recommended, which can take months to achieve. The goal of this collaborative effort is to achieve and enforce a cost reduced pharma plan.

Protecting the Injured

A pharmacotherapy review does more than just providing recommended clinically-proven drug alternatives that can reduce Payers’ costs. Expert clinical knowledge applied to the review of an injured workers’ prescription data and medical history can ensure a clinically appropriate and injury-specific pharmacy regime. All of which contributes to decreasing the potential of a negative cumulative impact such as adverse drug interactions, drug overdosing and other potential drug-related problems for the patient. The collaborative efforts of the prescribing physician and nurse expert, enforces a modified medical regime and future course of action that improves the injured workers’ overall quality of life.

For more information on ANS Solutions’ unique pharmacotherapy review program please contact us today.