Before July 1, 2017, California will have a newly established closed formulary
for all medications available for workers' comp claimants. The formulary
system, which has already been implemented in states like Texas and Washington,
is expected to not only cut down on pharmacy costs, but reduce potentially
dangerous opiate prescriptions.
As Business Insurance reports, Governor Jerry Brown signed the formulary bill, A.B. 1124, last month.
"A.B. 1124 will provide effective and evidence-based treatment for
injured workers while reducing delays and medical disputes," California
Chamber of Commerce policy advocate Jeremy Merz said in a statement. "This
legislation furthers the goal of a balanced workers compensation system
that provides timely benefits to injured workers and minimizes friction
in the system."
A.B. 1124 was inspired by an October 2014 study conducted by the California
Workers' Compensation Institute. They found that establishing a regulated
and continually updated formulary could potentially cut pharmacy costs
by $124 million to $420 million annually.
Reducing the Likelihood of Addiction
Beyond the financial reasons for the formulary, other advocates are championing
its potential effect on a growing issue within the workers' comp system:
addiction. According to experts, opiates are too often prescribed to injured
workers struggling with chronic pain, resulting in a higher rate of dependency
on prescription medication.
"California's upcoming drug formulary should result in prescribing
behavior changes away from dangerous prescription drugs and combinations
of drugs," said Mark Pew of PRIUM, a medical management company.
According Pew, the formulary will allow doctors and patients to steer
towards "more clinically appropriate means of managing chronic pain."
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