Legislative and Regulatory Trends: From Rhetoric to Practice
Contact Hours: 1.5 | Activity Type: Knowledge-based | ACPE UAN: 0233-0000-18-066-L04-P
The opioid epidemic caused over 42,000 deaths from opioid overdoses in 2016, with an estimated 40% involving prescription opioids. This crisis requires programs to implement tactics to prevent overdose, improve and expand treatment of substance abuse, and educate patients on appropriate opioid use. Federal agencies have developed guidance on opioid use, but specific recommendations vary. There are conflicting ideas on implementing benefit limitations based on this guidance. The inconsistency has driven states to enact legislation to combat opioid misuse and overprescribing. This can unintentionally result in under treatment of legitimate needs and potentially forces patients to turn to diverted or illicit drugs.
This session will demonstrate how a data-driven approach can reduce overdoses while promoting safe opioid use. The session will also explore how managed care pharmacists can develop data-driven strategies that balance utilization management with access to needed care by conducting analyses to determine patient characteristics, co-morbidities and utilization patterns associated with opioid adverse events, and identifying clinical outliers. Real world case studies showing successful payer strategies will also be discussed.
At the completion of this activity, participants should be able to: