- Stopping the drugs from being dispensed at the Point of Sale (POS, aka the pharmacy) is the most reliable way to enforce change
- Texas physicians were familiar with the preauthorization process after years of seeking approval for treatment such as physical therapy and spinal surgery
- ODG is the most reliably updated reference on the appropriate use of drug therapy available and is the standard of care in Texas
In my whitepaper, “Legacy Cleanup, Texas Style”, I document the fact that the use of “N” drugs within the first 90 days after Date of Injury (DOI) has been reduced by more than 50% because of Phase One. For DOI’s 9/1/10 thru 8/31/11, the proportion of “N” drugs to all dispensed drugs was 7.38%. For DOI’s 9/1/11 thru 12/22/11, that proportion dropped to 3.51%. This is real data from a major Pharmacy Benefit Manager (PBM) operating in Texas.
This analysis is corroborated by the DWC, who mentioned while I was in Austin last week that preliminary analysis shows a two-thirds reduction in the use of “N” drugs since 9/1/11 (across all claims, year over year).
Time will tell whether this is an anomaly during the first few days or a permanent trend. Regardless, this is REAL impact and REAL progress. But this is only the first phase, as I will discuss more tomorrow.
In this together – Mark
On Twitter @PRIUM1