The opioid crisis is at an unprecedented level, damaging the American economy and potentially impairing the health and productivity of employees.1,2 The numbers are alarming, with opioid misuse accounting for:
$10 billion annually in lost productivity and employee absenteeism.3
$15,000 in per-patient incremental annual health care costs.4
25 percent of all workers’ compensation costs.5
During a recent webinar, Dr. Richard Migliori, UnitedHealth Group’s chief medical officer and executive vice president, described the crisis as “one of the most daunting health emergencies of our time.”
But there are ways your clients can help fight back.
UnitedHealthcare — working with UnitedHealth Group and Optum — can help your clients with strategies across the care continuum designed to prevent and treat opioid use disorder (OUD), and improve opioid-related outcomes. These strategies have proven their ability to help:
Drive double-digit decreases in the use of long-acting opioids through new utilization management initiatives.
Deliver cost-effective, quality care in collaboration with network providers focused on substance use disorders.
Provide data and insights to help employers measure and develop customized, actionable solutions for their employees.
While OUD is a multifaceted problem without a one-size-fits-all solution, consider these 6 ways your clients can start helping their employees and minimize the impact of this health emergency on their companies.
1. Help educate employees.
Despite increasing national attention, the opioid crisis is thriving due in part to a lack of accurate information. Research suggests that as many as one in three prescription painkillers from employer-funded health plans are abused.6
“It’s important for employees to be aware of and understand the safety concerns associated with opioids,” said Susan Maddux, chief pharmacy officer at UnitedHealthcare. “That means communicating the risks of over-prescribing, overlapping treatments, abuse and side effects.”
Members of UnitedHealthcare medical plans that have Optum Behavioral Health coverage can access (at no additional cost) a confidential substance use and treatment helpline with specialized clinicians who provide treatment advocate services 24/7.
2. Encourage leaders to start and maintain conversations with employees.
It’s estimated that employees with substance use disorders miss nearly 50 percent more work days than their peers.7
An ongoing conversation with employees about this crisis can help them better recognize the signs of opioid misuse, including changes in mood and behavior, routine drowsiness and disorientation.
“OUD is a chronic illness that requires proper medical intervention,” said David Calabrese, vice president and chief pharmacy officer at OptumRx. “This is not a moral failing; it's a complex and chronic disease that requires medical intervention and long-term management. It's not something employees should be ashamed of. It's important for them to understand the resources available to them."
3. Empower employees.
“Employees should absolutely question a physician or dentist who is prescribing an opioid for them or a family member,” said Calabrese. “There are many safer and equally effective alternatives to help manage acute pain.”
It’s also important for those already addicted to be empowered to help seek safe and effective treatment. In most cases that means care from a network provider who incorporates what is known as medication-assisted treatment (MAT). Research shows that MAT provides greater potential for long-term recovery and reduces the likelihood of relapse by easing the symptoms of withdrawal and reducing cravings.8 Treated without MAT, people relapse at a rate of 90 percent. With MAT, the success rate is closer to 50 percent.9
UnitedHealthcare provides access to a network of MAT providers and collaborates with them closely to deliver quality, cost-effective treatment. We also can provide your clients with “heat maps” illustrating, for example, the relationship between opioid admissions for employees and the nearest network MAT providers. This can help your clients connect employees to a safe and nearby treatment program.
4. Offer employees alternative options for pain treatment.
Another way to help employees is by considering the addition of coverage for treatment alternatives as part of your client’s benefits plan. “Do employers have coverage for chiropractors, physical therapy, acupuncture, or other treatments that might help supplant the need for opioid prescriptions?” Maddux asks.
For example, the American College of Physicians recently published updated guidelines that support the use of pain treatments that don't involve prescription drugs for low back pain (one of the most commonly cited reasons for opioid prescriptions), including heat therapy, massage, acupuncture and spinal manipulation.10 At UnitedHealthcare, we actively integrate medical, behavioral and pharmacy treatments to enable a holistic, whole-person approach to helping reduce opioid misuse and dependence.
5. Consult with Pharmacy Benefit Managers.
Pharmacy benefits managers can recommend utilization management approaches that can help protect employees and their families from unsafe opioid exposure. These approaches can be based on the most up-to-date scientific evidence and guidelines for national bodies, including the U.S. Centers for Disease Control (CDC).
For example, following the implementation of utilization management strategies for long-acting opioids and exclusion of the market-leading brand, as of Aug. 1, 2017, UnitedHealthcare has seen significant improvement in utilization including:
An 18 percent drop in the number of members using a long-acting opioid.11
A 26 percent drop in days a patient using a long-acting opioid has treatment.11
A 15 percent drop in the average dose per day for long-acting opioids.11
6. Help prevent unlawful distribution.
Finally, employers can promote FDA guidelines regarding the safe disposal of unused medicines, including participation in take-back programs, says Maddux. Sixty percent of all U.S. households maintain leftover opioid medications, often in readily accessible, unsecured locations, and 7 in 10 opioid users reported getting opioids from a friend or relative without a direct prescription.12
“If a dentist prescribes 20 Vicodin but the patient only take four, it’s important to properly dispose of the rest, so they don’t fall into the hands of someone who could misuse or sell them.”
Building a customized solution.
While these 6 steps can help your clients get started in the fight against opioid misuse and its impact on the health and productivity of their employees, other strategies might also help reduce the impacts in their organization. We can work with you and your clients to develop a customized approach to help prevent the next addiction and treat those already suffering from OUD.
Learn more from the experts.
Webinar Replay: Tackling Substance Use and Opioid Addiction
Webinar Presentation: Download the Webinar Presentation
Expert: Dr. Richard Migliori, UnitedHealth Group chief medical officer and executive vice president
For more information, contact your UnitedHealthcare representative.
1 U.S. Department of Health and Human Services. The Opioid Epidemic: By the Numbers. https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf
2 Cheng, Evelyn. Here’s how the opioid epidemic is damaging the US economy, July 8, 2017. Business Insider. http://www.businessinsider.com/heres-how-the-opioid-epidemic-is-damaging-the-us-economy-2017-7
3 Coombs, Bertha. U.S. Companies Losing $10B a Year Due to Workers’ Opioid Abuse, April 20, 2016. NBC News. https://www.nbcnews.com/business/business-news/u-s-companies-losing-10b-year-due-workers-opioid-abuse-n559036
4 J Manag Care Spec Pharm, 2017 Apr;23(4):427-445.
5 Meinert, Dori. Combatting the Prescription Drug Crisis. HR Today. March 1, 2016. https://www.shrm.org/hr-today/news/hr-magazine/0316/pages/combatting-the-prescription-drug-crisis.aspx
6 Coombs, Bertha. U.S. Companies Losing $10B a Year Due to Workers’ Opioid Abuse, April 20, 2016. NBC News. https://www.nbcnews.com/business/business-news/u-s-companies-losing-10b-year-due-workers-opioid-abuse-n559036
7 National Safety Council (2017). http://www.nsc.org/Connect/NSCNewsReleases/Lists/Posts/Post.aspx?ID=186
8 Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49. DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1
9 Drug and Alcohol Dependence, 2015. https://www.optum.com/resources/library/medication-assisted.html
10 Qaseem, A. et. Al (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians. American College of Physicians. http://annals.org/pdfaccess.ashx?url=/data/journals/aim/936156/ on July 17,2017.
11 UnitedHealthcare Claims Analysis, July 2016 – June 2017.
12 U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. September 2014.