Express Scripts Significantly Reduces Inappropriate Selection and Excessive Dispensing of Opioids for New Patients

Jan 11, 2018

In the first 90 days since the program began on September 1, 2017, we observed a nearly 60% reduction in the average days supply for patients receiving an opioid prescription for the first time.

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  • Pain
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An initial review of our Advanced Opioid ManagementSM program shows that the comprehensive solution is protecting people using an opioid medication, particularly those taking an opioid for the first time. We’ve demonstrated an ability to help our clients address the national opioid epidemic by promoting greater compliance with CDC guidelines and significantly reducing excessive and inappropriate opioid prescribing.

90-Day Results

In the first 90 days since the program began on September 1, 2017, we observed a nearly 60% reduction in the average days supply for patients receiving an opioid prescription for the first time, from 18.6 days supply per prescription claim before the launch of the program, to 7.5 days supply per claim after the start of the program.

In addition, the program’s utilization management protocols ensured:

  • Nearly 96% of patients prescribed an opioid for the first time started with a 7-day supply or less;
  • Approximately 87% of patients prescribed opioids for the first time who were prescribed a long-acting opioid as initial therapy were redirected to safer, short-acting formulations.

Path Toward Safer Opioid Use

Our Neuroscience Therapeutic Resource Center (TRC) pharmacists are making a difference when it comes to getting patients on a path toward safer use of opioid medication through the hundreds of hours of conversations they are having with patients about opioid risks and safe disposal.

As part of the Advanced Opioid Management program, our TRC pharmacists provide proactive counseling on safe opioid use during calls with first-time opioid patients that last an average of 20-30 minutes in the comfort and privacy of the patient’s own home. To date, the program also has sent thousands of educational letters and safe disposal bags to patients who received an opioid prescription, and thousands of alerts to prescribers when a patient has accumulated an unsafe amount of opioid medication.

Comprehensive, Proactive Approach to Safer Opioid Use

Express Scripts Advanced Opioid Management is based on CDC prescribing guidelines and was pilot-tested in The Express Scripts Lab for six months with more than 100,000 members. The clinically driven program helps patients safely manage pain while limiting the potential for negative outcomes, such as opioid use disorder or death.

Working across the care continuum, the program shields patients and payers by minimizing early opioid exposure, helping to prevent progression to overuse or abuse, and encouraging the safe disposal of unused medications.

Because the opioid epidemic is such a complex issue, effectuating change requires addressing all parties that influence opioid decisions. Express Scripts is the first in the industry to address potential behavior and safety gaps at each touch point:

  • The patient, with whom we provide additional care and support to educate about safety concerns and proper disposal of medication;
  • The pharmacy, where our clinical edits mandate responsible dispensing in all pharmacy channels; and
  • The doctor’s office, where we alert physicians when a patient has accumulated an unsafe amount of opioid medication.

Seeing these types of results at such an early stage shows that by working together with our clients and introducing innovative ways to protect the safety of patients, we have the ability to make a significant impact. Our solution is positively impacting our nation and helping patients take better control of their health with additional knowledge, more support and less risk of becoming addicted to opioid medications.

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