Program uses comprehensive approach to reduce inappropriate
prescribing, dispensing and consumption of prescription opioids
Results show significant improvements in health outcomes for
patients and clients
EDEN PRAIRIE, Minn.–(BUSINESS WIRE)–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.
Reducing the opioid supply: Clients who adopted short-acting
opioid utilization management criteria experienced a 31 percent
decrease in opioid prescription volume and a 42 percent decrease in
the total morphine milligram equivalent (MME) 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 percent lower likelihood of these
patients progressing from short-term acute use to longer-term chronic
opioid use after the first fill.
Improving clinical best practices: In line with the Centers for
Disease Control and Prevention’s recommended best practices for
prescribers, 96 percent of opioid prescriptions among Optum customers
who adopted the program were in full alignment with dosage and
duration guidelines, vs. 55 percent 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,” said David Calabrese, chief pharmacy
officer at OptumRx. “We are honored to be recognized by PBMI for the
positive impact we are having on the patients and clients we serve.”
The OptumRx Opioid Risk Management program extends beyond what
traditional, stand-alone pharmacy benefit organizations can address by
targeting five key factors contributing to this complex health care
Prevention and education: Educating all stakeholders regarding
risks, proper dosing/duration, storage, safer treatment alternatives
and proper disposal.
Minimizing early exposure: Limiting opioid dose and duration of
therapy at first fill.
Reducing inappropriate supply: Applying protocols to reduce
excessive dosing, limit unnecessary extensions, mitigate abuse and
decrease exposure to harmful drug combinations.
Treating at–risk and high-risk members: Preventing
progression to chronic use, abuse and dependence through intensive,
multidimensional program efforts.
Supporting chronic populations and recovery: Guiding patients
with current or previous overdose experience/dependence issues/opioid
use disorder and providing advanced patient monitoring, support and
“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,”
said Jane Lutz, executive director of PBMI. “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
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
For more information on OptumRx’s Opioid Risk Management program, visit
our resource page.
OptumRx is a pharmacy care services company
helping clients and more than 65 million members achieve better health
outcomes and lower overall costs through innovative prescription drug
benefit services, including network claims processing, clinical
programs, formulary management and specialty pharmacy care. Through
expertise, flexible technology and a network of over 67,000 community
pharmacies and state-of-the-art home delivery pharmacies, OptumRx is
putting patients at the center of the pharmacy experience and making
health care more connected and less fragmented — ensuring patients get
the right medication at the right time at the best cost. OptumRx is part
of Optum®, a leading information and technology-enabled health services
business dedicated to making the health system work better for everyone.
Optum is part of UnitedHealth Group (NYSE:UNH). For more information,
or follow @OptumRx
The Pharmacy Benefit Management Institute (PBMI)
is the nation’s leading provider of research and education that informs,
advises, and influences the industry on topics related to drug cost
management. PBMI offers research, continuing education, and web
resources to help all critical stakeholders work better together to
optimize the overall value of drug benefit programs. Learn more at www.pbmi.com.
Tel: (952) 205-7747