Implementation of an Opioid Management Initiative by a State Medicaid Program

Thursday, May 1, 2014
Implementation of an Opioid Management Initiative by a State Medicaid Program
Maria Garcia, MD, MPH
University of Massachusetts Medical School
Kimberly Lenz, PharmD
University of Massachusetts Medical School
Paul L. Jeffrey, PharmD
University of Massachusetts Medical School

This article examines the impact of a 2-year stepwise initiative to reduce utilization and therapy costs of long-acting opioid analgesics (LAOA) by addressing issues of high dose, daily dose, and preferred therapeutic alternatives. The study successfully demonstrated that a state Medicaid program initiative can result in a significant overall decrease in opioid class utilization specifically for the targeted, more costly agents. This was achieved via the implementation of a Therapeutic Class Management multidisciplinary workgroup that established a prior authorization process implementing limits on dose, as well as identified preferred less costly agents. It further facilitated the direct opportunity for pharmacy-prescriber collaboration for LAOA medication management.