Defining Formularies & Step Therapy Medications
2 MIN READ
HealthCare.gov defines a formulary as, a list of prescription drugs covered by a prescription drug plan offering prescription drug benefits. Typically, a “prior authorization” for coverage is needed when a medication is not listed on the formulary or requires step therapy. Management of the formulary is often maintained by a pharmacy benefit manager (PBM), such as First Script. Meaning, when a medication is not on a formulary, First Script would start the prior authorization process to get approval for payment of the medication.
Opioids & Benzodiazepines...a Bad Mix?
2 MIN READ
There are certainly risks associated with combined use of an opioid and a benzodiazepine. Taking an opioid pain medication with other opioid medicines, benzodiazepines, alcohol, or other Central Nervous System (CNS) depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death. These risks occur because opioids and benzodiazepines affect the CNS, which controls most of the functions of the brain and body.
What Will Opioid Legislation do for Pharmacy and Opioid Risk Management?
2 MIN READ
In October 2018, Congress passed H.R.6, the “Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act” (also known as SUPPORT for Patients and Com
Changing Consumer Expectations: What Workers' Compensation Can Learn from the Healthcare Industry
What can workers’ compensation stakeholders learn from other industries in the age of automation and technology? In this article, we will explore how advances in the general healthcare industry and healthcare technology might influence changes in the workers’ compensation space.
Opioid Overdose Prevention and Treatment
1 MIN READ
Opioid management presents complex challenges, and early intervention is imperative to reduce risk and avoid dependence, addiction, or diversion.
Physician Dispensing and Opioid Abuse: Drug Dilemma Prevention Strategies
8 MIN READ
When it comes to challenges in workers’ compensation pharmacy, the industry trends are surprisingly similar year after year. Over the past few years, the issues of physician dispensing and opioid abuse have been in the national spotlight.
Quarterly Drug Update: Evaluating Combination Medications
6 MIN READ
Pricing for prescription drugs is a topic of much discussion. Combination drugs are often under scrutiny as a common practice for manufacturers to create new brand medications. While these combination drugs are effective, they may be more expensive and no more effective than their separate generic components that typically come at a significantly lower Average Wholesale Price (AWP).