The Impact of Opioid Safety Edits on Opioid Utilization

Objective To evaluate the impact of opioid safety edits on opioid utilization. Design Retrospective review. Setting Senior Care Action Network (SCAN) Health Plan, a Medicare Advantage Prescription Drug Plan. Patients, Participants The opioid safety edits reviewed included edits for the following: initial opioid fill more than 7 days’ supply (DS), cumulative opioid doses 90 or greater and 240 or greater morphine milligram equivalent (MME), concurrent opioid and benzodiazepine (COB) use. Members with prescription drug claims meeting these criteria pre- and postedit implementation and those with prescription drug claim rejections resulting from the edits were included in the review. Results 15,232 members experienced claim rejections resulting from the edits. Comparison of utilization pre and postedit implementation revealed the following results (P < 0.001): 41% decrease in the proportion of members with an initial opioid fill for more than 7 DS; 18% decrease in the proportion of members on opioid doses 90 MME or more; 26% decrease in the proportion of members on opioid doses 240 MME or more; 18% decrease in the proportion of members with COB. Conclusion Opioid safety edits are an effective way to combat overuse and misuse. They serve as a means for increasing collaboration between plans, prescribers, pharmacists, and members which improves care coordination, reduces adverse risks, and helps keep members safe.

A Time for Change: The Argument for National Pharmacare

Come this year I will be celebrating a milestone birthday, 25 years old. There are many significant milestones associated with that age; however, there is one milestone that I have been taking for granted… It is the age in which my parents’ employers drug plan will stop covering my medications. The realization that “free” medications were soon going to be a luxury of the past gave me a moment of pause, I asked myself, how does a country who prides itself on national healthcare still have people budgeting to buy life sustaining medications? The reality of that answer being the healthcare system we are so proud of is seemingly flawed.

Older Americans’ Preferences Between Lower Drug Prices and Prescription Drug Plan Choice, 2019

Objectives. To assess older Americans’ willingness to trade off the possibility of choosing or changing their prescription drug plan for lower drug spending. Methods. We used data from the Kaiser Family Foundation Health Tracking Poll on prescription drugs carried out in February 2019. This nationwide telephone survey oversampled participants aged 65 years and older who, when weighted, were representative of the US older adult population. Results. Older adults were strongly in favor of the government negotiating drug prices in Medicare Part D (82% support); 60% of older adults would trade off the possibility of choosing or switching their drug plan in favor of lower drug prices. All groups preferred lower spending over plan choice, but this preference was stronger among individuals who were in poorer health, had lower education and income, and found it very difficult to afford the drugs they needed. Conclusions. The results suggest that Medicare beneficiaries could support policies that limit plan choice, as long as drug prices actually decrease.

Efficiency Fast-Moving Drug Plan with Reorder Point Intervention at a Private Hospital in Bandung

Drug supplies are the major portion of the hospital expenses. The rising of drugs cost directly affect the total expenses of the hospital. Thus, their procurement, especially for fast-moving drugs, should be managed effectively. This study aimed to examine the efficiency of fast-moving drug plan after reorder point (ROP) intervention at a private hospital in Bandung. We conducted a pre-experimental study and used turn-over ratio (TOR) as a parameter. Data were taken from the stock of antibiotics in May-June of 2013 and May-June 2014. Cost components were collected; included the amount of stock, the cost of goods sold, and daily drug use. We did pre-test and post-test analysis to check the efficiency of intervention. The results showed that ROP intervention increased the efficiency of fast-moving drug plan. The comparison of pre- and post- intervention resulted a lower inventory value and a greater TOR value. We concluded that the increase in efficiency will eventually require a smaller budget of drug expenses.