Tampa, FL – myMatrixx, a pharmacy benefit management and ancillary medical services company serving workers’ compensation recently announced the release of a new case study resulting in savings of over $250,000 per year for one claimant. The study titled “Unmanageable or Simply Unmanaged? A Look Inside An Opioid Drug Treatment Case” reviews a clinical intervention with a catastrophic case including multiple opioids totaling over $27,000 a month. The case was brought to myMatrixx by Safety National who was concerned about the cost of this regimen as well as health risks for the injured worker.
During the twenty three year period of the claim, the treatment plan progressed from addressing a lower back strain injury to managing chronic pain syndrome. Opioid pain therapy was the primary course of treatment prescribed with a total of eight medications. Actiq was one of the opioids prescribed and attributed to 80% of the monthly costs alone. Additionally, the prescribed daily morphine equivalent dose (MED) was ~1331 mg, 13 times over the recommended limit and posed a serious risk to the patient.
After reviewing the drug therapy, myMatrixx’s clinical team consulted with the physician who agreed the treatment was out of the ordinary for the injury. He decided to discontinue the use of Actiq and pursue trials of generic alternatives for some of the other drugs in the regimen. The immediate result was seen in the estimated annual savings of over $250,000 for this one claim. Mitch Neuhaus, CPCU, Vice President of Claims for Safety National stated, “the claims administrator and defense counsel had tried for years to change the drug regimen without success. We would never have been able to get this patient off of Actiq without myMatrixx’s efforts.”
“In many cases making just one change in drug therapy can have a huge impact on a claim,” Phil Walls, R.Ph., Chief Clinical and Compliance Officer with myMatrixx added. “In this case the impact improved the patient’s care by reducing the serious risk of overdose while also delivering a significant savings to our client.”
The case study in its entirety from myMatrixx here: myMatrixx: Unmanageable Or Simply Unmanaged? A Look Inside An Opioid Drug Treatment Case (PDF)
For more information on myMatrixx’s Clinical Program, contact ltaylor@mymatrixx.com.
Source: myMatrixx