Document’s release coincides with director’s retirement
By Nick Trego, Clinical Operations Manager, Pharmacy Department
BWC’s communications department recently completed an infographic summarizing our work over the last six years to rein in excessive opioid prescriptions and the dangers they pose to injured workers, namely abuse, addiction and death.
Using a mix of colors, illustrations and statistics, the infographic is a roadmap of the steps we’ve taken to reduce the number of injured workers dependent on opioids from 8,029 in 2011 to 4,101 in 2016, a near 50 percent drop.
It’s called “Saving Lives — BWC battles the opioid crisis.” A better title might be, “Saving Lives — a tribute to John Hanna.”
Hanna, our pharmacy director, retires Sept. 29 after eight years in the job. More than anyone, it is John who is responsible for the achievements highlighted in the infographic, as well as for other pharmacy program reforms we’ve implemented to protect injured workers. Along the way, with the backing of BWC leadership, he also built a pharmacy department that is a model in the work comp industry today.
When John arrived at BWC in 2009, we had no real pharmacy department to speak of. It was essentially a mix of disparate services shared by various personnel in service offices throughout the state. We had no formulary, no clinical review committees. Controls and best practices were low. Costs and drug utilization were high. For a system that experienced more than 100,000 new injured workers a year, we had to do better.
What followed over the next several years were a series of improvements to reduce inappropriate prescribing of opioids and other dangerous drugs. We created a Pharmacy & Therapeutics Committee of six physicians and six pharmacists to provide recommendations on all medication-related policy. We created the first work-comp-specific closed formulary in the nation. We stopped coverage of any new opioid formulation until it was reviewed by our P&T Committee. And in 2016, we implemented a rule that requires providers to use a set of best practice guidelines when prescribing opioids. If they don’t follow those guidelines, they risk losing their BWC certification.
To further demonstrate our commitment, we offer injured workers who meet specific criteria up to 18 months of paid recovery services if the treatment for their workplace injury leads to an opioid addiction.
In other enhancements, we developed an automated program that flags claimants with high-risk medication regimens. We implemented “electronic edits” that require all drugs in medical-only claims to have a prior authorization to continue to be covered past 60 days. The same goes for workers who’ve had no claim activity for 270 days. We became the first state agency to cover naloxone products, as well as the first state agency to add Abuse Deterrent Formulations of opioids as a choice for prescribers. And earlier this year, our board of directors approved a rule restricting first prescriptions for opioids to seven days or 30 doses.
Our work has garnered local and national media attention, and work comp programs across the country are calling us, wanting to mirror our success. Topping it off, we wound up saving our agency money. That’s right, I said “saving.” For every dollar we spent on reforms, 50 came back to us in savings. All told, our department spends nearly $49.6 million less on medications today than we did in 2011.
Not that any of this was cost-driven. John always told us, “If we implement best clinical practices, the savings will follow.”
Earlier this year, Gov. Kasich recognized John for his efforts, awarding him the Governor’s Award for Employee Excellence. The industry has recognized his efforts, too. Just last month, the International Association of Industrial Accident Boards and Commissions named John and our team winners of its 2017 Innovation Award.
None of this was easy, but John kept us focused on one guiding principal: “Do what’s best for the injured worker. That’s why we’re here.”
Click here for more on BWC’s efforts on the opioid front.