EnvisionRx Prioritizes Opioid Safety with Multi-Faceted Pain Management Program

Pharmacy benefit manager’s enhanced program helps payers safely address
members’ pain and lower risk of abuse

Program helps educate and guide patients prescribed opioids to safely
use these powerful drugs

TWINSBURG, Ohio–(BUSINESS WIRE)–In response to the nation’s opioid epidemic, pharmacy benefit manager, EnvisionRx,
a division of EnvisionRxOptions, announced enhancements to its
comprehensive opioid and pain management program, EnvisionCare Pain
Management. Available immediately, the program includes pre-emptive
prescription strategies, such as limiting first-time fills to seven
days*, prior authorizations on certain medications, and shortened
windows to refill prescriptions. This comprehensive program aligns with
the healthcare company’s overall pain management strategy, as well as
the guidelines set by the Centers for Disease Control and Prevention

“As our nation endures a health crisis around opioid dependency, we are
in a unique position to change the way opioids are used by our members,”
explained Frank Sheehy, chief executive officer of EnvisionRxOptions.
“Prescription fill limits and monitoring as a part of our pain
management program will help minimize the risk of opioid addiction,
especially for those patients who are being prescribed opioids for the
first time.”

EnvisionCare Pain Management, which includes an opt-out feature for
clients not wishing to implement this program, focuses on patient safety
through communication, education and outreach, as well as interventions
that avoid excessive dosing and dangerous drug combinations, ensuring
pain is managed safely before and after the first dose.

The program contains pre-dispense, concurrent and retrospective
measures, such as:

  • 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.”


* 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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