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New York could join states launching prescription drug formularies

Posted On: Oct. 17, 2016 2:50 PM CST

The New York State Workers’ Compensation Board is seeking public comment on a proposal to create a prescription drug formulary, adding onto a list of states that are considering formularies for the treatment of injured workers. 

The proposed formulary would be part of a pharmacy benefit plan announced by the New York workers comp board earlier this month. In a statement this month, the board listed a myriad of reasons for its proposed plan, including a rapidly-changing prescription drug market and a need to ensure that injured workers are receiving medically appropriate drugs for their injuries.

“(Currently) there is no drug formulary in place; no requirement for pre-approval/prior authorization; no process to ensure the appropriateness of the prescribed medications,” the statement reads. 

New York is part of a number of states that have introduced or are considering workers comp prescription drug formularies.

For example, Montana’s Labor Management Advisory Council is gearing up for a second meeting in November to discuss the possibility for a workers comp formulary.

Eric Strauss, Helena, Montana-based administrator for the employment relations division at the Montana Department of Labor and Industry, said the state has placed its “focus is on narcotics and overutilization and better outcomes” for injured workers. 

“Nationally, that’s a trend,” he said. “We want to provide good outcomes for workers and there’s evidence that formularies work.”

Tennessee launched a workers comp drug formulary in August and California is set to begin using a formulary by mid-2017.

Arkansas, Louisiana and Mississippi also are in early talks to establish formularies, said Brian Allen, Westerville, Ohio-based vice president of government affairs for Optum Workers’ Comp and No-Fault Auto, a pharmacy benefit manager and managed care firm.

Mr. Allen said many states have been inspired by the launch in 2013 of a closed drug formulary in Texas, which has seen good results

“(Texas) saw a reduction in the use of opioids and significant cost savings along with an improvement in their return to work numbers,” he said. “It is working and it’s getting results (so) other states are looking at it.”