Recently, I participated in the BHC Pharmacy Management Initiative's fascinating forum on the Opioid Epidemic. We all know opioid misuse weighs heavily on American society, as the statistics in the text box to the left demonstrate.
But there is good news. Each speaker offered new and meaningful solutions. Here are some highlights:
1) The Centers for Medicare and Medicaid Services (CMS) has evaluated and tested interventions to reduce the hazards of opioid use among Medicare enrollees. They now mandate a maximum opioid dose per month. The use of a standard calculation which converts all opioids prescribed to a Morphine Equivalent Dose (MED) has made this possible. In any given month, when a prescription exceeds this amount, the patient encounters a "hard stop" at the pharmacy. Alerts are also provided. Of course, hospice care and certain diagnoses exempt a patient from this safeguard. Medicare's early results warrant your consideration - so ask your health plan or PBM about a prior authorization for the MED.
2) Congratulations to the St. Louis County Department of Public Health for getting St. Louis County's Prescription Drug Monitoring Program (PDMP) organized so quickly and thoughtfully. It will go live in April and was developed to easily enable other municipalities to participate. Seven are already working together. At the outset, the program will cover a large portion of Missouri. The County appreciates the wide business and public support it has received and welcomes your help in spreading physician awareness of this coming resource.
3) Dr. Michael Bottros of Washington University's Pain Management Center underscored that overprescribing and misuse of prescribed opioid medications are major sources of this problem. You might think that as a pain management physician specialist, opioid use would be higher in his patient population. I did, and I was wrong. A fairly small portion of his patients use these medicines. I also learned that for 1 out of every 5 patients undergoing a knee replacement, their joint pain continues after surgery. The good news is that there are many effective alternatives and more coming. New neurological interventions to control pain can help patients manage back, joint, and other pain.
Meeting slides can be found here and more details are available from local expert and BHC Product Manager, Dave Heaton.
BHC Executive Director