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Two drugs to be added to disability guidelines' preauthorization list

Posted On: Jan. 8, 2016 12:00 AM CST

Two powerful drugs used to treat injured workers soon will be reclassified as nonformulary drugs by the Work Loss Data Institute, according to the Texas Department of Insurance's Division of Workers' Compensation.

In addition to all long-acting opioids such as Duragesic and MS Contin, Embeda and Levo-Dromoran will require preauthorization as of Feb. 1, the Texas comp division said in a statement on Tuesday.

Embeda, the brand name for morphine extended release and naltrexone, is currently recommended by the Encinitas, California-based Work Loss Data Institute's Official Disability Guidelines as an option for patients who are at risk for abuse of opioids.

Meanwhile, Levo-Dromoran, the brand name for levorphanol, is used for moderate to severe pain when an opioid is appropriate for therapy, according to the guidelines, which are the foundation of closed drug formularies and treatment guidelines in states like Texas and Oklahoma.

Closed drug formularies help combat the overutilization of opioids by requiring proof that nonformulary drugs, or “N” drugs, are medically necessary before they can be prescribed to injured workers. Drugs with a “Y” status, such as aspirin and ibuprofen, don't require preauthorization.

In the statement, the division said “the purpose of notifying system participants is to allow time to review and prepare for transition of these drugs … (it) will continue with its outreach efforts to inform and work with injured employees, prescribing doctors, pharmacies, and insurance carriers.”