How Morbid is This?
The Centers for Disease Control (CDC) has a catchy little publication called “Morbidity and Mortality Weekly Report” (MMWR). On July 3, 2012 they posted on their website the results of a study of methadone, spanning the period 1999-2010. The focus was to analyze the number of deaths resulting from methadone and whether the deaths were disproportionate to the amounts of methadone prescribed.
You probably have claimants who are (or have been) using methadone for chronic pain management. The results say:
Methadone overdose deaths and sales rates in the United States peaked in 2007. In 2010, methadone accounted for between 4.5% and 18.5% of the opioids distributed by state. Methadone was involved in 31.4% of OPR (opioid pain reliever) in the 13 states. It accounted for 39.8% of single-drug OPR deaths. The overdose death rate for methadone was significantly greater than that for other OPR for multidrug and single drug deaths (emphasis added).
The report also states that only those health care providers with substantial experience should be prescribing methadone and insurers should require authorization for starting doses exceeding 30 mg per day. Insurance formularies should NOT list methadone as a preferred drug for the treatment of chronic noncancer pain.
Yes, sweating the details of pharmaceutical utilization review is complicated. We know because we do it every day. But it can make a huge difference in medical costs and saved lives.
Call us. We can do better.
William V. Faris, JD