Nobody is immune from the effects of opioid misuse. A tragic number succumb to fatal overdoses—one every 13 minutes. Addiction also leaves its mark on both personal and professional lives. For example, those impacted by pain medication use disorder missed nearly three times the amount of work in the past year than did the general workforce. Lost productivity costs employers about $20 billion, a 2015 study found.
Safety is also an issue; employees under the influence of opioids may experience dangerous side effects—including sedation, confusion, and poor judgment— that put them, as well as others, at risk. This is especially true for employees in potentially dangerous jobs, such as big-machine operators or restaurant workers responsible for food safety. And even though opioid prescription use among people with large employer insurance coverage has declined, the cost for treatments has escalated to $2.6 billion.
Only a coordinated, multifaceted approach can reverse the opioid epidemic. Plan sponsors and their PBMs need a risk management strategy that hits the problem on all fronts, such as the five-point program from OptumRx. These five areas include:
It’s early days yet, but the signs are hopeful. PBMs that have implemented strategies and programs to manage opioid use are seeing positive outcomes:
PBMs play a critical role in successfully reversing the effects of the opioid crisis. Most of them demonstrate an unwavering commitment by offering opioid management as part of their core services to plan sponsors. One area where they can make a significant difference is assisting employees or members who struggle with opioid misuse. Too often, these individuals fear they will lose their job if they seek help. PBMs can encourage the adoption of return-to-work policies that offer a safe haven. And by supporting local recovery programs, PBMs can improve access to recovery and treatment options in local communities. If you’re a plan sponsor, check with your PBM or pharmacy benefit consultant to see how you can help win the war on opioid misuse.
Learn more about the causes of the opioid crisis in our first blog post in this series. Next time, I’ll discuss additional strategies that employers and other plan sponsors can consider.