March 20, 2018

Trending Pharmacy Cost-Driver: Topical Packs & Kits


A tube of Voltaren® Gel (diclofenac), a commonly prescribed topical non-steroidal anti-inflammatory drug (NSAID), will cost a payer $60. Yet when it is packaged together with antibacterial wipes, its list price may be about nine times this cost, at $500. Convenience packs, or “co-packs” are not a new concept in workers’ compensation. However, there has been…[Continue Reading]

Moving Beyond Opioid Analgesics


While many people are aware of the risks of misuse, abuse, addiction and even overdose that accompany the use of opioid analgesics, not everyone understands the profound affects they can have on nearly every body system. Last summer you met Anne, a 45-year old woman who injured her back at work. Over the course of her claim…[Continue Reading]

Controllable Risk Factors in Diagnostic Imaging for Injured Workers


Advanced imaging, including the magnetic resonance imaging (MRI) and computed tomography (CT) scans frequently used in workers’ compensation, help physicians diagnose workplace injuries and develop effective treatment plans. Numerous studies show that advanced imaging has improved medical outcomes in the areas of declining mortality, reduced…[Continue Reading]

New Clinical Decision Points in Drug Therapy


Decision points and intervention opportunities regarding a patient’s drug therapy can vary over the lifetime of a claim and per individual patient. Up front, basic interventions such as having a drug formulary in place can put a claim on the right path from the start, while well-established and more complex claims might require more strategic clinical…[Continue Reading]

Using a Multifaceted Approach to Break the Sleep-Pain Cycle


We’ve all experienced those times when much-needed sleep was elusive or have been woken up in the middle of the night only to find you just can’t get back to sleep. Whether caused by stresses from social obligations, work, or home responsibilities, an occasional bout of insomnia, while frustrating, is relatively harmless. However, for those…[Continue Reading]

The Differing Effects of Opioid Analgesics


While many are concerned about the potential for misuse and abuse that comes with the utilization of opioid analgesics, an additional challenge is the side effects opioid analgesics can cause. You may have met Anne, a 45-year-old woman who injured her back at work. Helios shared her story in July to demonstrate how opioid analgesics have the potential…[Continue Reading]

Can 3D Printing Lend a Hand to the Workers’ Compensation Industry?


Over the past 10 years, 3D printing has become a more accepted and better-understood manufacturing process. Many herald the new technology as revolutionary, if not transformative to a variety of industries, ranging from industrial design to manufacturing. Use of 3D printing technology is recognized as particularly impactful to the medical…[Continue Reading]

Drug Utilization Management: Have You Tapped Its Full Potential?


Managing appropriate utilization of prescription medications is a critical component of balancing quality and cost of care in workers’ compensation. The concept seems intuitive: by delivering the most appropriate care to a patient, you’ll also come out ahead from a cost perspective – with better outcomes, shorter claim durations, a lower likelihood…[Continue Reading]

The Formulary Journey


In what seemed at times to be a herculean effort by Assembly Member Henry Perea and his staff, the California Legislature passed AB1124 in the waning minutes of the 2015 legislative session, helping smooth the way for the development of a drug formulary to guide the treatment of injured workers in California. The journey for AB1124 began earlier…[Continue Reading]

Shining a Light on Formularies: Can PBM and State-Specific Formularies Work Together? We Say Yes.


A formulary is an approved medication list often based on clinical review of evidence-based medicine and both nationally and regionally approved medical guidelines. Both group health and workers’ compensation pharmacy benefit managers (PBMs) have been using formularies for decades to control prescription utilization and costs…[Continue Reading]

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