In another effort to stem the opioid epidemic, insurance and employer advocates supported the creation of a pharmacy formulary for workers’ compensation, House Bill 592, but it died in committee.
Proponents, such as the Louisiana Association of Self-Insured Employers, say other states like Texas have curbed opioid abuse and prescription costs by adopting a formulary. A pharmacy formulary for workers’ comp requires that providers prescribe medicine from an approved list. To prescribe medication not on the list, they must obtain approval. Oxycontin, for example, must be pre-approved because of its high abuse potential.
“I think an appropriate formulary designed with evidence-based guidelines is what we need,” says Troy Prevot, executive director of LCTA Workers Comp.
“This would guide people to safer first-line drugs to manage their pain while healing,” adds Andy Condrey, claims manager at The Gray Insurance Company.
Texas was among the first of at least eight states to adopt a drug formulary in 2011. By 2014, a Texas Department of Insurance study found the number of injured employees receiving non-approved drugs decreased 65% and costs of the drugs decreased 82%.
The Louisiana Legislative Auditor’s Performance Audit Services prepared a report on workers’ compensation costs in 2015 that recommended adopting a formulary to reduce prescription costs and abuse. The audit found narcotic painkillers prescribed to state employees accounted for at least 24% of prescription costs from 2006 to 2013.
But not everyone is on board with a formulary. Opponents say the actual goal is to save insurance companies money by making it difficult for injured workers to get needed medicine. This could be why the formulary bill stalled in this year’s legislative session, but proponents plan to bring it up again for consideration next year.
The Louisiana Workforce Commission contends prescription painkiller abuse is already declining due to awareness and other legislation aimed at combating the issue. Judge Sheral Kellar, director of LWC’s Office of Workers’ Compensation Administration, says the state must treat the opioid epidemic as an overall health issue, not just a workers’ compensation issue. She notes that Louisiana workers’ comp claims have already seen a 7% drop in opioid prescriptions, according to WCRI.
“While Louisiana obviously has a long way to go,” Kellar says, “these figures are promising.”