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Comp industry hopeful implant will fight opioid addiction in injured workers

Comp industry hopeful implant will fight opioid addiction in injured workers

Workers compensation experts say the first implant that would treat opioid addiction could be a useful tool in preventing overdoses and deaths for injured workers who qualify for the treatment.

The Probuphine implant approved for use last month by the U.S. Food and Drug Administration, consists of four, matchstick-sized rods that provide a constant low-level dose of buprenorphine, a drug that treats opioid dependence by stopping cravings for such medications.

Before the implant, the detox drug was only approved to be taken as a pill or a film placed under the tongue or on the inside of a person's cheek until it dissolved. The implant can last for up to six months, according to the FDA.

A patient's eligibility for the implant will need to be considered before treatment can occur, according to Probuphine's manufacturers, South San Francisco, California-based Titan Pharmaceuticals Inc. and Princeton, New Jersey-based Braeburn Pharmaceuticals. The drug makers recommend the implant for patients who are taking a buprenorphine dose of no more than 8 mg per day and say that patients should actively participate in counseling and psychosocial support.

These criteria narrow down substantially the workers comp candidates eligible for Probuphine, said Mark Pew, senior vice president at Duluth, Georgia-based medical management company Prium. However, he said he expects there will be injured workers that fit the criteria and whose treating physicians will make the request.

It will take a little time up front for the implant to make its way into workers comp though, as doctors are only now being trained on how to insert the implant, Mr. Pew said. Evidence-based medical guidelines also will need to be updated to inform workers comp utilization reviewers or peer reviewers on the use of Probuphine in comp claims, he said.

Walker Taylor, Wilmington, North Carolina-based managing director of life science practice group of Arthur J. Gallagher & Co., said the implant will be highly desirable for workers comp patients.

“The main thing is getting the worker back to work sooner. One of the big drivers in workers comp costs is lost time,” Mr. Taylor said. “If this can help control lost-time injuries and help workers get back to work faster, then there's going to be a lot of interest in this treatment, if it can prove to drive down costs.”

Probuphine patients will need to be seen during the first week after insertion and at least once monthly afterward, Mr. Taylor said. This “heavy involvement” with injured workers could be a good thing, he said, because it will allow medical providers to more closely monitor the recovery of workers comp claimants.

“There is a lot of monitoring of big claims within the insurance industry, especially with the major carriers and people who are serious about monitoring and controlling comp costs and getting people back to work,” Mr. Taylor said. “This implant is for professional companies that are serious about controlling costs.”

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