OptumRx receives PBMI's 2019 Excellence Award for opioid management strategies

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OptumRx receives PBMI's 2019 Excellence Award for opioid management strategies

By Sandra Levy - 03/06/2019
Pharmacy services company OptumRx has received the 2019 Excellence Award for Opioid Management Strategies from the Pharmacy Benefit Management Institute.

The award recognizes OptumRx for significantly reducing excessive prescribing, dispensing and consumption of prescription opioids – while delivering quality care – through its Opioid Risk Management program, a comprehensive initiative addressing the opioid epidemic.

Since the program’s launch in July 2017, OptumRx has successfully helped clients and patients balance the need for these powerful medications with the risk of abuse and misuse by:

  • Reducing the opioid supply: Clients who adopted short-acting opioid utilization management criteria experienced a 31% decrease in opioid prescription volume and a 42% decrease in the total morphine milligram equivalent exposure among patients receiving opioid prescriptions;

  • Decreasing progression from acute to chronic use: Clients who adopted first-fill dose and duration limits for patients not receiving opioids on a daily basis showed a 50% lower likelihood of these patients progressing from short-term acute use to longer-term chronic opioid use after the first fill; and

  • Improving clinical best practices: In line with the Centers for Disease Control and Prevention’s recommended best practices for prescribers, 96% of opioid prescriptions among Optum customers who adopted the program were in full alignment with dosage and duration guidelines, vs. 55% national average.


“Using advanced data analytics and evidence-based clinical strategies, we are mitigating opioid misuse and abuse before it starts, while supporting people who may be battling dependency and addiction issues, as well as those in recovery,” OptumRx chief pharmacy officer David Calabrese, said. “We are honored to be recognized by PBMI for the positive impact we are having on the patients and clients we serve.”

“OptumRx’s Opioid Risk Management program stands apart because of its dual focus on reducing both the consumption and prescription of opioids, enabling the company to achieve unparalleled results on both fronts,” PBMI executive director Jane Lutz said. “Knowing that OptumRx is continually updating the program to advance positive results for its members, we look forward to the work that is to come.”

OptumRx is continuing to expand its efforts to curb the rise of opioid abuse through a variety of new components recently launched and in development, including: more aggressive first-fill dose and duration limits (3 days; 50mg/day) for children and young adults; decreased opioid dispensing through OptumRx Home Delivery Pharmacy to a maximum of 30-day supply only, which helps reduce excess supply and supports safe and appropriate opioid use; and
adherence monitoring and intervention for patients on medication-assisted therapy.

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