|Pharmacy Benefit Management Institute Recognizes Anthem for Medicare Opioid Case Management Strategies|
“More people are addicted to opioids and dying from overdose than ever
The Opioid Overutilization Management Program was originally developed
to meet criteria from the
Anthem’s programs review the last year of opioid use and then exclude members with diagnoses of cancer, as well as members receiving hospice care. Members’ prescribers are notified when members exceed program criteria on number of prescribers, pharmacies and morphine equivalent daily dose.
“Often, prescribers won’t realize that the member is filling more prescriptions for opioids written by other prescribers,” said Devanshi Sheri, clinical pharmacist who leads the program for Anthem’s Government Business Division. “Our program allows prescribers time to work with the members by looking at all their prescriptions and diagnoses holistically to assess their need for opioids. Our case managers work in tandem with the prescribers to either keep a close watch on the member to allow time for a resolution or reduce benefit coverage at the pharmacy to prevent unsafe use.”
Anthem has been identifying ways to help consumers obtain better access
to treatment while also putting into place policy changes that help
reduce opportunities for addiction. Anthem is committed to helping its
affiliated health plans double the number of consumers who receive
About Anthem, Inc.
Anthem is working to transform health care with trusted and caring solutions. Our health plan companies deliver quality products and services that give their members access to the care they need. With over 73 million people served by its affiliated companies, including approximately 40 million within its family of health plans, Anthem is one of the nation’s leading health benefits companies. For more information about Anthem’s family of companies, please visit www.antheminc.com/companies.