Kimberly George, Sedgwick

1. Sedgwick © 2013 Confidential – Do not disclose or distribute.
Managing the pain of
prescription drug costs:
Defining the solutions
http://blog.sedgwick.com/2013/05/21/managing-the-pain-of-prescription-drug-costs-defining-the-solutions/

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Today medication prices are rising faster than any
other medical expenditure
Overview
• Powerful narcotics and opioids are fueling these
expenditures
• These narcotics are becoming more commonly
prescribed in response to work-related
injuries.

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Defining the Solutions
Creation and use of an effective workers’ compensation
formulary
Ensuring claims examiners and nurse case managers receive
notification based on select triggers.
Review the injured worker’s complete medical history, using both
in network and out of network transactions
Utilize close monitoring when narcotics or opioids are prescribed

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Defining the Solutions
Require follow up appointments within three days and only
authorize three days of initial treatment
Educate and inform employees of the benefits, dangers, and
alternatives for narcotics and opioids
Use of a comprehensive and focused network of pharmacies and
prescribing providers
Rely on advanced technology systems

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Defining the Scope
Many of these medications were not originally intended
to treat occupational injuries.
Little evidence to support benefits of their long-term or
widespread use in the workers’ compensation arena.
High risk for abuse

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Follow up appointments
Employee education
Pharmacy clinical reviews
Strong network of pharmacies
Prescribing providers
Technology
Strategies and Solutions

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Kimberly George
SVP, Managed Care Practices
and Client Services
Kimberly.George@sedgwick.com
http://blog.sedgwick.com/