OPIOID RISK MANAGEMENT
The Serve You Rx Opioid Risk Management Program comprehensively addresses the misuse of prescription opioids and its consequences through monitoring, education, and intervention.
The program addresses the crisis of abuse and addiction, and the associated problem of rising costs, by reducing the likelihood of misuse through a multitude of proactive and retrospective approaches in four areas, including analysis, safeguards, education, and access to treatment modalities.
- Real-time analysis is performed on every submitted claim to detect duplicate prescriptions, early refills, excessive dosages, and unusual lengths of therapy.
- Opioid prescribing patterns, the dispensing patterns of pharmacies, and member utilization are retrospectively reviewed to identify those at risk.
- Formularies promote clinically appropriate drug use and generic utilization, achieving the best value from a clinical, cost, and member satisfaction perspective.
- Our pharmacists use a national prescription drug monitoring database to evaluate each prescription in the context of a member’s entire therapy, including prescriptions received from other pharmacies.
- Limits are enforced in alignment with CDC guidelines on the days’ supply, number of units, and refills within a given time period.
- Medical necessity of opioid use is confirmed before benefit coverage is approved, consistent with FDA recommendations on diagnosis and dose.
- Plan savings is achieved by requiring lower cost preferred medications before more costly alternatives are covered.
- Appropriate cost control and care management strategies are developed with guidance from the FDA to prevent fraud, waste, and abuse.
- Our website provides information about the proper disposal of unwanted medication.
- Our pharmacy ships a DisposeRx packet with each order containing an opioid.
- Clients are provided with useful, detailed reports about their membership’s opioid utilization.
- Educational content and resources, including presentations and articles, are available for a variety of audiences.
ACCESS TO TREATMENT MODALITIES
The pharmacy benefits administered by Serve You Rx include best practice plan design inclusions.
- Access to naloxone as well as Medication-Assisted Treatment
- A non-pharmacologic digital therapeutic option called reSET-O
Community Support for Recovery
We recognize our role in the pharmaceutical supply chain and our obligation to combat this crisis. To that end, Serve You Rx has committed substantial resources toward recovery advocacy and ending the stigma of opioid addiction. This includes sponsorship of The Voices Project and Mobilize Recovery and launching Wisconsin’s Nalox-Zone Community-placed Opioid Overdose Prevention Project.
The Nalox-Zone Project
Serve You Rx launched the Nalox-Zone Community-Placed Opioid Overdose Prevention Project in 2020 to save lives by strategically placing containers equipped with the overdose-reversing medication naloxone in select locations around Wisconsin communities. The locations are in areas identified as “hot zones” due to repeated incidences of overdose in or near those areas. Each box contains naloxone (brand name Narcan) nasal spray, instructions on how to administer the drug, and information about resources for treatment and recovery support.
Mobilize Recovery is working to equip a network of leaders in all 50 states with tools, training, and a plan of action that can be employed in communities throughout America to inspire recovery and end the preventable overdose crisis. As the corporate voice in the movement, Serve You Rx is serving as a resource and motivating companies to replicate the recovery-friendly workplace culture Serve You Rx has established. Read the Serve You Rx Recovery-Friendly Workplace Credo.