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Duragesic will join the other six forms of fentanyl considered nonformulary drugs under the Work Loss Data Institute's Official Disability Guidelines.
As of Feb. 1, Duragesic, the brand name for fentanyl transdermal patches, also will require preauthorization, meaning physicians must prove it's medically necessary before they can prescribe the pain medication for injured workers.
At one time, people thought other forms of fentanyl, such as the Actiq lollipop and the Lazanda nasal spray, were harder to control than patches, said Mark Pew, senior vice president at PRIUM, a Duluth, Georgia-based medical management company. But that's not the case, he said.
There has been an increasing amount of evidence regarding the dangers of all forms of fentanyl, including topical Duragesic, Phil Denniston, president and CEO of the Encinitas, California-based Work Loss Data Institute, said in an email.
He said fentanyl is approximately 80 times more potent than morphine.
Tighter control of long-acting opioids is expected to change prescribing behaviors, but workers compensation claim payers should watch for an uptick in the use of other powerful narcotics.