Opioid addiction and overdose are leading causes of death in the United States, according to the US Dept. of Health and Human Services. State Fund recognized the growing crisis of opioid use well ahead of the national conversation on the issue. As early as 2013, State Fund’s Medical Director crafted a comprehensive opioids management strategy.
One important step our Medical Director took was to work with Medical Provider Network (MPN) physicians to modify opioid prescribing habits, limiting use to short term and requiring utilization review for any longer term use. We also collaborated with the University of California, Berkeley’s Center for Occupational and Environmental Health to provide Continuing Medical Education credits to the physicians who take pain management training. Additionally, MPN physicians worked to wean those injured workers with long histories of opioid use to either reduce or eliminate their dependence on these dangerous drugs in a safe, controlled way. This multi-pronged approach to curbing opioid use has been very successful in reducing the prevalence of opioids in the claims State Fund manages.
In 2015, claims costs for opioid medications was $1.22 million per month for State Fund. By 2016, monthly costs dropped to $720,000. In 2017, that amount was reduced to $49,000 per month. The volume of opioids as a percentage of total scripts is down from 24% in 2015 to 16% in 2017. The dollar savings are substantial; more importantly, the potential impact these programs have on saving lives could be significant.