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    3 New Initiatives Target Opioid Crisis

    The opioid crisis is still getting worse—so what's being done about it?

     

    Prime Therapeutics Adds Care Managers to the Equation

    Patrick Gleason, Senior Director, Health Outcomes for Prime Therapeutics, says that a new paradigm is changing the treatment of patients with pain. Instead of setting a goal of totally eliminating pain, providers should focus on keeping patients safe and avoiding the risk of dependence while decreasing pain, he says.  

    Using predictive modeling, Prime Therapeutics is using a program that combines:

    • Concurrent drug utilization review (cDUR) which flags potential dispensing problems for pharmacists to address, such as duplicate prescriptions.
    • Utilization management to establish quantity limits and prior authorization.
    • Retrospective DUR using Prime Therapeutics’ clinical rules to notify prescribing physicians of patients who are at high risk and require attention.
    • Guided Health Care Program that includes case management, hard edits, quantity limits, and a lock-in program.

    The program contributed to a 71% reduction in high-risk opioid use and a 16% decrease in opioid claims for Prime’s commercial book of business between the first halves of 2012 and 2017.

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    Mari Edlin
    Mari Edlin is a freelance writer based in Sonoma, California.

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