EnvisionRx Prioritizes Opioid Safety with Multi-Faceted Pain Management Program

• Clinically focused safeguards, like a seven-day limit on prescriptions for patients who have not used an opioid in the past three months, step therapy for extended-release opioids and prior authorization for extremely high dosages (greater than 200 Morphine Milligram Equivalents (MME)).
• Safer dispensing practices, including real-time drug utilization reviews at the pharmacy to promote proper dispensing and point-of-sale alerts for excessively high dosages or those who have been prescribed dangerous drug combinations.
• Supplemental, detailed reviews, in addition to those the pharmacist performs at the time of dispense, to identify patients who may be filling high dosage opioids, and/or receiving prescriptions from multiple prescribers and dispensers. These reviews, paired with a shortened refill window requiring patients to have exhausted 85% of their medication supply before a refill will be dispensed, help identify dangerous long-term utilization and members who may be in need of intervention.

Programs like these that include controls from before the first dose to retrospective reviews have shown impressive results, such as an annual 42% reduction in the number of opioids filled and a cost reduction of nearly 30%.[1] Additionally, these programs help control indirect costs, such as absenteeism, presenteeism, and added medical expenses due to opioid abuse, which studies show account for eight times more direct healthcare costs than those of non-abusers.[2]

“We firmly believe that by reducing the number of opioids in the hands of a new patient right from the start, we can significantly decrease the possibility of dependence and addiction,” stated Sheehy. “While opioid use can have positive results for pain management, we have a responsibility to protect our members by addressing pain in an appropriate way and better educating patients about the risks accompanying opioids.”

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* Member requested adjustments to this days’ supply limitation are subject to prescriber review and direction through the prior authorization process.

[1] EnvisionRx internal reports (2018). [2] Fudin (2015). The economics of opioids: Abuse, REMS and treatment benefits. American Journal of Managed Care, Vol 21, No 9. August 2015.

About EnvisionRxOptions and EnvisionRx

A wholly owned subsidiary of Rite Aid, EnvisionRxOptions is a pharmacy services and healthcare company with a visibly different approach to pharmacy benefits. The company’s pharmacy benefit manager (PBM), EnvisionRx, is URAC-accredited for Pharmacy Benefit Management and Drug Therapy Management (DTM). The first PBM to offer true transparency, EnvisionRx provides flexible, customizable services, such as traditional and pass-through pricing, unique network and formulary design, and specialty pharmacy care. Using its proprietary EnvisionCare model, EnvisionRx optimizes all aspects of the pharmacy care experience to consistently achieve better patient and plan outcomes. For more information, visit envisionrx.com.

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