Texas limits access to opioids for comp injuries

Two powerful opioids soon will be reclassified as nonformulary drugs on Texas' closed drug formulary, according to the Texas Department of Insurance, Division of Workers' Compensation.

Prescriptions for fentanyl transdermal patches and MS Contin will require preauthorization as of Feb. 1, the division said in a statement on Wednesday. The drugs are approved by the Federal Drug Administration to treat moderate to severe chronic pain.

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.

The division said it “encourages system participants to begin discussing and coordinating the ongoing course of treatment if fentanyl transdermal patches and/or MS Contin are currently being prescribed.”

Texas' formulary, which comes from the Official Disability Guidelines, published by the Encinitas, California-based Work Loss Data Institute, lists Duragesic as the brand name for fentanyl transdermal.

Of the seven forms of fentanyl included on the formulary, Duragesic is the only one that isn't already considered an “N” drug. Other forms include the Actiq lollipop and the Lazanda nasal spray.