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Tpp 5 paduda victor
1. Latest
Research
on
Impact
of
Rx
Drug
Abuse
on
Workers
Compensa:on
Joseph
Paduda,
President
CompPharma,
LLC
Dr.
Richard
A.
Victor,
Execu:ve
Director
Workers’
Compensa:on
Research
Ins:tute
2. Disclosures
• Joseph
Paduda
has
financial
rela:onships
with
proprietary
en::es
that
produce
health
care
products
and
services.
These
financial
rela:onships
are:
consul:ng
for
CID,
Millennium
Labs,
and
MedRisk,
Inc.
• Richard
A.
Victor
has
disclosed
no
relevant,
real
or
apparent
personal
or
professional
financial
rela:onships.
3. Learning
Objec:ves:
1. Specify
workers'
comp
stakeholders'
current
aQtudes
towards
opioids,
the
programs
they
have
in
place
to
address
opioids,
and
how
they
are
measuring
success.
2. Explain
the
impact
of
prescrip:on
drugs
on
workers'
compensa:on
costs,
disability,
and
outcomes.
3. Compare
the
level
of
understanding
of
execu:ves
to
front-‐
line
staff
to
assess
gaps
in
performance
and
policy
implementa:on.
4. Specify
what
types
of
physician
dispensing
of
opioids
exist
and
how
common
these
prac:ces
are
used.
5. Analyze
whether
a
ban
on
physician
dispensing
of
opioids
reduces
the
use
of
opioids
or
merely
shiYs
the
dispensing
to
pharmacies.
4. Latest
Research
on
Impact
of
Rx
Drug
Abuse
on
Workers
Compensa:on
Joseph
Paduda
President
CompPharma,
LLC
6. As a society we consume
of all the opioids prescribed
in the world.
80%
pg.
2
7. DEA definition
“opioid”Examples include the illicit drug heroin and
pharmaceutical drugs like:
OxyContin®
Vicodin®
codeine
morphine
methadone
and
fentanyl
pg.
3
8. Routine use of opioids
for the treatment of
chronic nonmalignant
pain conditions
is not recommended.”
“
-ACOEM
pg.
4
9. The number of narcotics
prescriptions per claim
has grown 41%, from
0.56 in 2003 to 0.79 in 2011.
-NCCI
pg.
5
10. Respondents
400 total, 2:1 front line:
executive ratio
272 completed the survey
Response rate is three times
greater than any other
survey we’ve conducted
over 10 years.
pg.
6
12. When you hear the word
“opioids,” what one or two
words instantly come to mind? Addiction /
Dependence
Drug(s) /
Narcotics /
Drug Name
Abuse
Appropriate /
Pain / Pain Killer /
Therapy
Cost
Over Prescribed /
Death / Danger /
Epidemic
Death
pg.
8
14. Why? Because these drugs drive up
costs, duration – most respondents have
figured this out and are starting to track
the impact.
pg.
10
15. Opioids are perceived
as having
overwhelmingly
negative
consequences for
payers and claimants.
What is the impact of opioids on the
costs and outcomes of workers’
compensation claims?
pg.
11
16. Whose responsibility is
it to manage opioids?
Addicts may be
“responsible” but
aren’t capable, and
many doctors
aren’t able to
address the issue.
pg.
12
17. How effective or ineffective
have PAYERS been in
addressing opioids?
pg.
13
18. What is causing PAYERS
not to effectively address
the issue of opioids?
Regulations Don’t Allow
Payers to Do Enough
Tools Available
Are Inadequate
Not Able to Identify Claims That
Would Benefit From Intervention
Other (Please Specify)
Not a Top Priority pg.
14
20. Conclusion
major problem as it directly affects
claim costs
duration
risk
ability to control same
As with any WC issue, payers look
to regulators to enable solutions –
however there are some solutions
currently in place that are delivering
results despite the less than
helpful environment.
pg.
16
25. Please describe what
the vendor(s) is(are)
doing to address
opioids?
There’s a discrepancy
between front-line staff
and management, which
indicates a disconnect with
internal communication.
pg.
21
26. What is the vendor doing to address opioids?
pg.
22
27. How are you measuring the impact
of the work of the vendor(s)?
pg.
23
28. We’re in this early stage
where much of what we’re
doing is based on what we
think will work, but we
don’t yet KNOW.
Do you believe the programs
are having a positive effect?
pg.
24
29. What should be done?
What is being done?
80% of respondents picked best practices.
vs.
pg.
25
30. The ideal solution
80% identified:
Peer / physician review for claims – 90 / 180 days
Drug utilization review
Random drug testing
Opioid agreement / contracts
pg.
26
31. Please rank the following potential solutions
1-8 in the order that you believe would be
most successful in addressing the overall
opioid issue starting with 1 as most successful.
pg.
27
32. What percentage of the claims with opioid
issues do you think an opioid management
program would address?
pg.
28