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The California closed drug formulary for workers compensation will be updated quarterly by a committee of three doctors and three pharmacists who will meet several times a year, according to the California Division of Workers Compensation.
Workers comp stakeholders tuned into an hour-long webinar Wednesday that aimed to introduce the industry to the adopted California closed drug formulary set to go into effect on Jan. 1. The webinar was led by division officials and those who helped develop evidence-based guidelines under American College of Occupational and Environmental Medicine, which the formulary is based on.
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 and gives providers a guide for when and how to prescribe based on evidence-based guidelines. It was officially adopted on Dec. 7.
California’s formulary divides drugs between exempt and nonexempt classifications; categorizing drugs that are not subject to a utilization review and those that are, respectively. All opioids are on the nonexempt list, meaning the medications are not evidence-based under most care and will require a utilization review, which can be expedited, according to Jackie Schauer, an attorney with the division’s legal unit.
Opioids can be prescribed for four days without a review, according to the list of drugs and rules guiding each. Per the regulations, the formulary gives patients already on a regular regimen of opioids and their doctors three months to eliminate, reduce or justify the prescription.
Concerns about perceived ambiguity in the review process for non-preferred drugs and the lack of inclusion of opioids on the list of preferred, evidence-based medications are some of the reasons major stakeholders in the workers comp space are calling for delayed implementation of California’s drug formulary.