Medication safety program on safe prescribing procedures for narcotic drugs launched

Aug 20 2009

Warnings by the Food and Drug Administration (FDA) and increasing misuse and overdoses are telling reminders of the dangers pain medications can present. A recent study reveals that one in 10 high school students have tried opioid drugs and the prevalence of young adults using narcotics for non-medical use is the highest in 15 years. As an advocate for patient safety, Independence Blue Cross (IBC), in conjunction with its pharmacy benefits manager, FutureScripts(R), has launched a medication safety program to expand on safe prescribing procedures for narcotic drugs.

The new program can save lives by identifying potentially dangerous drug interactions, and may also reduce medical costs when the appropriate medication is prescribed and used properly. It can also help to ensure that underlying medical problems are diagnosed and properly treated to avoid the long-term dependency on pain medication.

Since the late 1990's, the abuse, misuse, and overdose of prescription drugs have increased significantly. According to the Centers for Disease Control and Prevention, each year more than 20,000 people in the United States die from drug overdose -- many accidental, and the most common drugs cited are opioids, or narcotics like hydrocodone and oxycodone.

"Claims data showed multiple instances where our members were being prescribed up to ten different pain killer drugs from three or more doctors within a short period of time," said Dr. Jennifer Dragoun, a medical director for FutureScripts who manages this program. "In reviewing these cases, it was clear action was necessary to ensure patient safety."

IBC and FutureScripts began implementing the new patient safety program in May, and the medical directors and pharmacists focus on the following types of clinical situations:

• instances where members are taking multiple, similar medications, in some instances prescribed by two or more doctors who are unaware that another physician has prescribed a similar drug;
• instances where members' claims show they may be taking too much of one drug. Excessive quantities of narcotic pain medication may have severe side effects and overdose can result in death;
• instances where a dependency concern may need attention, which can result in approved coverage of medications for a limited time while the member and his or her physician pursue alternative treatment;
• instances where a combination of prescribed medications contain doses of acetaminophen, (commonly known as Tylenol). An FDA panel recently made strong recommendations regarding the damaging effects acetaminophen may have on the liver if too much is taken.

In any of these circumstances, the member is notified about the unsafe prescription drug use and its potential dangers, with an explanation that changes may have to be made for their pharmacy plan to cover future prescriptions. In certain circumstances, an IBC or FutureScripts medical director will discuss the patient situation with the member's doctor to resolve the matter.

Dr. Dragoun explained that some of the potential causes for recent increases in prescribing and misuse of pain medications are:

• members seeing multiple doctors, each of whom prescribe drugs for them, not knowing that similar narcotics are being prescribed by other doctors;
• an increase in substance abuse and drug dependency issues;
• acquisition of narcotic drugs or prescriptions for sale to others.

"Our goal is to put our members' safety first and protect them from the dangers of powerful drugs that may not be taken appropriately," said Paul N. Urick, R.Ph., senior vice president of FutureScripts. He added that while extra precautions help to ensure patient safety, they also help to control health care costs for employers, members and the community.

Because IBC understands members may have questions about getting the medications they need, or difficulty managing chronic pain, health coaches are available around the clock to answer questions, help members formulate the right questions for their doctors to decide on treatment plans, and refer members to case management programs to address underlying problems or mental health providers to address dependency.

"We're pleased to add this program as a complement to our drug utilization review programs, with the expectation that this too will generate positive results," said Dr. Richard Snyder, senior vice president of Health Services at IBC. "It's an extremely high priority at IBC to continuously improve the quality of patient care for our members."

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