How UMass Medical School is helping MassHealth, the Massachusetts Medicaid program, promote more rational use of opioids is highlighted in a Specialty Pharmacy Continuum article on managed care efforts to address the nationwide addiction crisis.
“What’s becoming more common is payors looking at dangerous combinations of medications—such as opioids with benzodiazepines—where they feel the member is at risk for overdose or respiratory depression,” said Kimberly Lenz, PharmD, a clinical pharmacy manager in UMass Medical School’s Office of Clinical Affairs and and an assistant professor at the medical school.
“Our health system is looking for ways we can manage this class while striking a balance of appropriate access,” said Lenz, who presented on the topic of opioid medication management strategies at the Managed Care Pharmacy Managed Care & Specialty Pharmacy 2017 annual meeting.
Lenz and Tyson Thompson, a clinical consultant pharmacist in UMass Medical School’s Clinical Pharmacy Services, shared best practices in opioid management and the steps MassHealth has implemented to better manage opioid utilization.
UMass Medical School designed a therapeutic class management team to execute the opioid management program for MassHealth. The team includes Lenz, a clinical pharmacy manager, a board-certified psychopharmacology pharmacist, two clinical consultant pharmacists - one being Thompson - and an operations supervisor pharmacist.
The program implements several steps to better manage opioid use among MassHealth members. One of these steps places distribution limits on all long acting opioids in order to make sure doses are given at their proper frequency.
“Overall, 78 percent of the interventions were successful—that is, when prescribers accepted their recommendations or provided more information establishing medical necessity,” Thompson said about the initiative.
The program has reduced the average daily dose of IR oxycodone and extended-release morphine sulfate by 10 percent and 9 percent respectively. Products like oxycodone ER saw a 13 percent decrease and morphine IR saw decreases of up to 15 percent.