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Express Scripts says opioid program making a difference

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ST. LOUIS — As President Trump signs bipartisan legislation to help improve our nation’s response to the opioid abuse epidemic, Express Scripts  released new data today showing a dramatic shift in first-time opioid users enrolled in its Advanced Opioid Management solution being prescribed safer, short-term prescriptions of 7 days or less. Short-term opioid prescriptions can significantly reduce the risk of a patient misusing or abusing a medication. The new opioid law supports Express Scripts’ ongoing efforts by strengthening our ability to work collaboratively with patients, prescribers, pharmacies, and plan sponsors to help stop opioid abuse and misuse.

In just one year, Express Scripts’ Advanced Opioid Management solution has seen enrolled clients achieve notable results that align with recommendations put forth earlier by the U.S. Centers for Disease Control and Prevention:

• 93% of patients prescribed an opioid for the first time started with a 7-day supply or less;
• 77% of patients prescribed a long-acting opioid as initial therapy were redirected to a safer, short-acting medication; and
• The average day’s supply per claim for first time opioid users dropped 55%, from 18.6 days prior to enrollment to 8.3 days.

Overall, clients that adopted our utilization management criteria saw an average of 94.8% of opioid prescriptions covered for 7 days or less after one year. In addition, these clients also experienced a 73.2% average decrease in the number of prescriptions for more than a 7-day supply.  These two data points support why Express Scripts’ Advanced Opioid Management solution is the leading program among all large PBMs serving 20 million or more patients.

“While the root causes of opioid abuse and misuse are complex, we know that engaging patients, prescribers, and pharmacies at critical touchpoints can mitigate the potential for abuse – and we’re proud of the results of our Advanced Opioid Management solution,” said Snezana Mahon, vice president and general manager, clinical and trend solutions.  We applaud Congress and the Administration for acting decisively to require electronic prescribing of controlled substances and the development of new electronic prior authorization standards.”

One year ago, Express Scripts launched the PBM industry’s first and most comprehensive Advanced Opioid ManagementSM solution. Recognizing the breadth of the opioid crisis, Express Scripts’ Advanced Opioid ManagementSM solution works comprehensively by touching the physician’s office, the patient’s home and pharmacy. Working with key stakeholders, we rely on innovative data analytics, physician engagement and proactive outreach to shield plan sponsors and members from this devastating crisis. Importantly, the solution does not apply to cancer patients or patients who are receiving hospice or palliative care.

Express Scripts has recently expanded its point-of-sale strategy to closely monitor three commonly abused medications that, when combined with opioids, increase the risk of dangerous side effects and overdose.  This work complements the SUPPORT for Patients and Communities Act (HR 6), which was approved with overwhelming bipartisan support and signed into law this week by President Trump.  The SUPPORT for Patients and Communities Act is a critical step forward in helping to eliminate the scourge of opioid abuse, particularly for Medicare and Medicaid beneficiaries.


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