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Express Scripts Research Shows Prescription Drug Utilization Declines for Payers of Workers' Compensation
Date:4/22/2013

ilities of the behavioral sciences, clinical specialization and actionable data."

Programs that help control utilization include Oral Fentanyl Intervention and Long-Acting Narcotics outreach to physicians. Express Scripts also offers step therapy, narcotics education for injured workers and physicians, Drug Utilization Review, Physician Peer-to-Peer, and formulary management programs.

One product that helps manage trend for clients is a communication program that encourages injured workers to use lower-cost generic equivalents. The product is based on the findings of an Express Scripts research pilot which demonstrated how injured workers who received a letter explaining how their prescription drug choices could help control the rising cost of healthcare were 60% more likely to choose a generic equivalent.

Preventing Abuse to Drive Down Costs

Express Scripts offers a comprehensive first-of-its-kind fraud, waste and abuse program for workers' compensation payers to better manage narcotic utilization. Narcotics comprise more than a third of the cost and utilization in workers' compensation, and given the potential for misuse and abuse, payers need a focused approach to managing their use.

"Our fraud program combines our unique data analytics with clinical expertise and investigative services in a proven solution that increases savings for payers and safety for injured workers by reducing narcotics misuse and abuse," Pokorney said

In the U.S., prescription drug overdoses result in 1.2 million emergency room visits and more than 15,000 deaths each year — more than cocaine and heroin combined.

"We look for patterns of behavioral red flags to find cases that may otherwise be missed," he said. "We leverage thousands of tips each year and constantly refine our algorithm and da
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SOURCE Express Scripts
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