An article published last month in the New York Times states that the sales of opioids (prescription painkillers such as OxyContin) have increased 110% in the last ten years; what was less than a $4 billion industry in 2001 is now nearing the $10 billion mark. This article is one of many that has been published recently detailing staggering findings and pulling the curtain on a highly addictive drug market. Although many prescriptions in this domain are necessary to treat pain sustained from injury, the exponential growth of patients in addiction treatment facilities due to opioid abuse has insurance and pharmacy benefit organizations on high alert.
Many benefit management companies are finding that internal resources which are necessary to adequately assess a member’s treatment plan are lacking. There is often not a singular person who reviews the regimen holistically to ensure that physicians of varying specialties are not supplying the same patient with conflicting or excessive medications. Not only is this a dangerous gamble for one’s health but the price of repeatedly approving prescriptions is costing patients and insurers a significant amount of money. One report estimates the average non-opioid work comp claim to cost $13,000, while those with long-term use of the drugs jump to $117,000.
AMR works with clients in this industry to evaluate the overall health of an individual and gauge the necessity of medications; our physicians not only look at the need for each, but also determine if any appropriate generics may be a substitute, if the duration of treatment is appropriate and if the individual could best be served with an alternative therapy solution. This method has worked to reduce the risk of unnecessary illness or death, as well as be an efficient workflow for cost containment, making it a win-win option for clients.
Dr. Alpern’s clinical experience in Orthopedic Surgery has included training in trauma surgery, joint replacement, sports surgery, hand surgery, and spine surgery. Eytan has presented and published multiple scientific papers covering diverse areas of research including: stem cell biology, immunology, transplant surgery, and bone development and repair.
By DR. EYTAN ALPERN
