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California moving forward with comp drug formulary starting Jan. 1

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The California Division of Workers’ Compensation is proceeding with its evidence-based drug formulary for medical providers treating injured workers starting Jan. 1, 2018, the division announced on Thursday.

The drug formulary, the implementation of which was delayed six months for regulators to make adjustments, establishes a list of medications available to injured workers. It’s a trend in workers compensation, as several states including Washington and Texas have passed similar formularies in an effort to improve prescribing behavior and to limit opioids medications for pain.

California’s formulary includes a cap on opioid prescribing on the first fill with provisions for doctors to submit to a review process to prescribe further. It also gives patients already on a regular regimen of opioids and their doctors three months to eliminate, reduce or justify the prescription.

For pain management, the formulary relies on anti-inflammatory drugs, which medical experts have said lack the addictive side effects of opioids.

“The adoption of the drug formulary is a step forward for California’s injured workers and should help address the overuse of high-risk medications such as opioids,” the division’s Administrative Director George Parisotto said in a statement. “It is expected to improve patient care and ease approval of appropriate treatment.”

The formulary will be part of the state’s Medical Treatment Utilization Schedule, which contains guidelines on treatments for injured workers and is based on medical treatment guidelines created by the American College of Occupational and Environmental Medicine, according to the division.