There were almost 4,000 opioid-related deaths in Canada in 2017, according to Health Canada statistics released in June.
Meanwhile, in the United States, a new survey by the National Business Group on Health found 60 per cent of large employers had experienced at least one issue stemming from prescription opioid misuse or abuse in the workplace. Forty per cent of survey participants said they’ve seen an increase in medical or pharmacy costs for chronic opioid users, while the same percentage reported absenteeism among chronic opioid users and 18 per cent have had employees overdose on prescription opioids.
With no signs the opioid crisis is abating anytime soon, what steps can employers take?
One option is requiring a prior authorization before members are reimbursed for drugs with a high potential for misuse, according to Joan Weir, director of health and disability policy at the Canadian Life and Health Insurance Association. As well, they can delist certain high-strength or long-acting opioids.
Insurers are making progress in working with plan sponsors on the issue, says Weir, noting this includes sending information to plan members, supporting better prescribing practices and looking for duplicate claims.
“The industry has long done that, but is now looking at it with respect to narcotics.”
Another strategy is to limit prescriptions of narcotics to a maximum 35-day supply. “That’s an easier one to do when the provinces already move to do that,” says Weir. “It’s a little bit more difficult if it’s the insurer or the employer or plan sponsor who’s making that decision. But yes, I’d say every insurer has been taking steps to put some supports in place and to work with their plan sponsors to make sure [they] can also put restrictions or supports in place for their employees.”
Looking at coverage for better treatment options is another way plan sponsors can help employees, notes Weir. “So rather than the opioid route, supporting potentially more physical therapy or cognitive behavioural therapy or psychology.”
Christine Than, a pharmacist and drug solution specialist with Aon’s health and benefits practice, feels the employer’s actions should be twofold. First, when it comes to drug plan management, the employer can make certain the insurer or payor has mechanisms in place to flag potential abuse, such as early refills and duplicate therapies. Second, they can perform drug utilization reviews on a regular basis to ensure everything is close to the benchmark.
Employers should also ensure their employees are aware of the programs that are available to help them, she says.
“Employers need to make sure that employees and their managers know that there are some resources available through the health plan for people who have drug dependency problems,” says Than. “It could just be making sure that employees know that there are [employee assistance] programs that can address these issues and know to refer these people to those programs if a problem is ever flagged.”