Beating the Odds Against Opioid Abuse

Oct 1, 2018
As we enhance our Advanced Opioid Management program, Express Scripts continues to aggressively combat opioid abuse, find solutions to address prescribing trends and build on our work across the care continuum.

Rochelle Article

When you think about your home town, do you think about the effects opioid abuse has had on it?  Most people do. Across the U.S., the opioid epidemic is taking a staggering toll on families, neighborhoods, hospitals and clinics, and the workplace.

At Express Scripts, our home base is St. Louis, but our reach extends across the nation and beyond. We are focused on fighting opioid misuse, which is why we're launching enhancements to our Advanced Opioid Management program - at no extra charge to enrolled clients, effective Oct. 1.

The program is already significantly reducing inappropriate and excessive dispensing of opioids for new patients. With these enhancements, we’re making program improvements at the pharmacy and physician level that go beyond what other pharmacy benefit managers offer.

Expanding Point of Sale Safety

A key component in the fight against opioid misuse is the ability to get the right amount of the right drug in the right dosage to the right patient.  Together with our clients, Express Scripts is curbing opioid misuse by reducing the average days' supply in each prescription by nearly 60%, from 18.6 days’ supply of medication per prescription claim before the launch of our program, to 7.5 days’ supply per claim.

With the launch of the enhanced program, we're expanding our point-of-sale strategy to three commonly abused medications that, when combined with opioids, increase the risk for dangerous side effects and overdose. In addition to opioids, we’re implementing a point-of-sale strategy for benzodiazepines, carisoprodol, and gabapentin.

Benzodiazepines, which include Valium and Xanax, affect the central nervous system. They are used to treat conditions like anxiety, insomnia and seizures. More than 30 percent of overdoses involving opioids also involve benzodiazepines.

Carisoprodol is a muscle relaxant that is prescribed to treat muscle pain and spasms. It intensifies the effects of other drugs and drug combinations, and it can be severely addictive and potentially dangerous.

Gabapentin is prescribed for seizures and neuropathic pain as well as other conditions including bipolar disorder, migraines, insomnia and anxiety. In 2016, gabapentin was the 10th most prescribed medication in the U.S. and misuse was low among the general population at 1%. That number has increased to between 15 to 22% among those who misuse opioids.

Providing More In-depth Personalized Patient Consultations

Specialist pharmacists from our Neuroscience Therapeutic Resource Center® (TRC) are professionals in clinical consultations who have open, non-judgmental discussions with members. They reach out to members based on a protocol that alerts pharmacists to potential overuse. By discussing potential health outcomes with the patient, our TRC team may prevent the patient from beginning chronic use of opioids.

This consultative care builds on our proactive private and customized outreach in response to one of four proven trigger warnings from our proprietary data sets and modeling signals concerning patterns of use.

Increasing Influence With Physician Education and Peer Comparison

We want to ensure prescribers have the information they need at the point of care.  In addition to prescriber educational messaging and customized opioids prescribing patterns of comparison to peers, we’ll now review prescribing practices that include opioid-adjacent therapies. By bringing attention to prescribers with outlier patterns, we can quickly influence behavior and reduce the risk of misuse.

Advancing Member Education and Protection

Our members are at the heart of our Advanced Opioid Management program, and and we’re expanding our outreach to them.  We’ll send an educational letter to anyone refilling an opioid prescription after their plan  enrolls in the program, and we'll send letters when a new opioid prescription is filled. We’ll give members information about benzodiazepine, gabapentin and muscle relaxants if they use any of these medications with opioids. 

Safe handling and proper disposal of leftover medications continue to be an important part of our program.  We'll continue to provide simple-to-use deactivation kits that allow patients to dispose of unused opioids safely.

When patients seek treatment to stop using opioids, our specialist pharmacists are trained to provide counseling and education regarding medication-assisted therapy to withdraw from opioid use.

The Leader in Advanced Opioid Management

No other pharmacy benefit manager offers such a broad scope of proactive strategies and depth of consultations with members and physicians.

The right strategy to help stop our country’s deadly opioid epidemic starts here. Contact your Express Scripts representative to learn more about how Advanced Opioid Management can reduce your costs and keep members healthier.

Author Bio

Kelcey Blair
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