OptumRx Significantly Reduces Opioid Prescribing With Management Program

Pharmacy benefit manager OptumRx has reported initial results of its Opioid Risk Management Program, including significant reductions in prescriptions for first-fill acute opioid treatment, prescriptions for chronic users, and prescriptions that exceed Centers of Disease Control (CDC) dose recommendations. Based on this early success, OptumRx also announced that it plans to roll out the program nationwide.

“OptumRx’s program is showing early but meaningful potential to begin curbing the opioid epidemic in America,” said Sumit Dutta, MD, chief medical officer of OptumRx. “We expect these improvements to continue as the program gains momentum and we implement with more clients.”

The program uses point-of-service interventions in prescribing, dispensing and consumer use to reduce inappropriate consumption and to increase alignment with CDC guidelines. It places a maximum fill limit on opioid medications whether the patient is new to opioids or a chronic user. OptumRx is able to initiate interventions by leveraging clinical, analytics and administrative services and its connections to patients, providers and pharmacists.

Since launching on July 1 with more than 400 clients, the program has reduced prescriptions above the CDC recommended dose by 85% and reduced prescriptions for first-fill acute opioid treatment written above the maximum 7-day supply by 65%. It has also decreased prescriptions for current chronic opioid users by 68%. Further, the average dose across all opioid prescriptions has been reduced by 14%.

“Recognizing this is an issue that can affect any segment of our population at any point in time, successful opioid management programs must tailor engagement based on the needs of an individual,” David Calabrese RPh, MHP, chief pharmacy officer at OptumRx, said in a press release. “The right level of prevention and care must be delivered, at the right time, to the right stakeholder–using multiple channels and touchpoints –before a member even receives a first opioid prescription through to the effective support and management of those well entrenched in battles to fight this devastating epidemic.”

—Julie Gould (Mazurkiewicz)