Panel Discussion:Using Workers’ Compensation

Formularies to Reduce Rx OpioidsPresenters:

• Joseph Paduda, MS, Principal, Health Strategy Associates

• Mark Pew, Senior Vice President, PRIUM

Third-Party Payer Track

Moderator:

• Michelle C. Landers, JD, Executive Vice President and General Counsel, Kentucky Employers’ Mutual Insurance, and Member, Rx and Heroin Summit National Advisory Board

Disclosures

Joseph Paduda, MS; Mark Pew; and Michelle C. Landers, JD, have disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.

Disclosures

• All planners/managers hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

• The following planners/managers have the following to disclose:– John J. Dreyzehner, MD, MPH, FACOEM – Ownership interest:

Starfish Health (spouse)– Robert DuPont – Employment: Bensinger, DuPont &

Associates-Prescription Drug Research Center

Learning Objectives

1. Explain how workers’ compensation formularies reduce opioid prescriptions.

2. Describe the operations and outcomes of formularies in such states as Texas, Ohio, Oklahoma and Washington.

3. Identify best practices for designing and implementing a workers’ compensation formulary.

4. Provide accurate and appropriate counsel as part of the treatment team.

Panel Questions

• Describe a Commercial drug formulary in 10 words or less.

Panel Questions

• Describe a Commercial drug formulary in 10 words or less.

• Describe a Workers Compensation drug formulary in 10 words or less.

Panel Questions

• Describe a Commercial drug formulary in 10 words or less.

• Describe a Workers Compensation drug formulary in 10 words or less.

• How and why are the two different?

Panel Questions

• Where do formularies “fit in” to the overall medical and claims management process?

Panel Questions

• What’s the better approach – drug specific or condition/disease state?

Panel Questions

• Why do we need formularies in Work Comp?

Panel Questions

• Identify the top three “guiding principles” for a successful Work Comp drug formulary.

Panel Questions

• What is THE outcome that would demonstrate success?

Panel Questions

• Who are the stakeholders affected by formularies and the formulary process? How do the different types of formularies address their needs or change their processes?

Panel Questions

• What did Texas do right with their Work Comp drug formulary and related programs?

Panel Questions

• What did Texas do right with their Work Comp drug formulary and related programs?

• What did Texas do wrong with their Work Comp drug formulary and related programs?

Panel Questions

• What can non-monopolistic states learn anything from Ohio and/or Washington?

Panel Questions

• Will Tennessee’s new drug formulary be a success?

Panel Questions

• If opioids are prescribed less, how is chronic pain treated?

Panel Questions

• Is it really that tough to address “legacy claims”?

Panel Questions

• Are pharmacy benefit managers just a commodity with a state-mandated drug formulary?

Panel Discussion:Using Workers’ Compensation

Formularies to Reduce Rx OpioidsPresenters:

• Joseph Paduda, MS, Principal, Health Strategy Associates

• Mark Pew, Senior Vice President, PRIUM

Third-Party Payer Track

Moderator:

• Michelle C. Landers, JD, Executive Vice President and General Counsel, Kentucky Employers’ Mutual Insurance, and Member, Rx and Heroin Summit National Advisory Board