Experts from UMass Medical School said managed care plans can use a variety of tools to combat the opioid crisis, including a therapeutic class management team, according to an article in Pharmacy Practice News.
The tools, which also include medication restrictions and dose limits, and what makes them so effective at controlling opioid use were broken down in the article by Kimberly Lenz, PharmD, clinical pharmacy manager in UMass Medical School's Office of Clinical Affairs and Tyson Thompson, PharmD, a clinical consultant pharmacist in UMass Medical School’s Clinical Pharmacy Services. The pair recently presented on the model at the Academy of Managed Care Pharmacy Managed Care & Specialty Pharmacy 2017 annual meeting.
“Our health system is looking for ways we can manage this class while striking a balance of appropriate access,” Dr. Lenz said in the article. She is also an assistant professor of Family Medicine and Community Health.
Lenz and Dr. Thompson are members of a team that developed and now delivers an opioid medication management program for the MassHealth, the Massachusetts Medicaid program. They designed a therapeutic class management team to execute the opioid management program for MassHealth. The team includes Lenz, a board-certified psychopharmacology pharmacist, two clinical consultant pharmacists - one being Thompson - and an operations supervisor pharmacist.
Opioid management strategies include dose and quantity limits and setting distribution limits on all long-acting opioids in order to make sure doses are given at their proper frequency.
Lenz said it’s difficult to develop guidelines around the best opioid use strategies because many organizations have opinions on some facet of the issue. The UMass Medical School team, however, develops evidence-based guidelines using current best practices that are universal because they cover a broad range of patient circumstances.
The UMass Medical School team uses those guidelines and the above-mentioned strategies to better manage opioid use among MassHealth members. When applicable, the team will connect directly with prescribers to suggest alternative regimens or medications. In all, 78 percent of interventions were successful, meaning the prescribers either accepted the UMass Medical School recommendation or provided proof of medical necessity.
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.