Pharmacy Solutions
Ask The Pharmacist
Your workers’ compensation and auto-related pharmacy questions answered.
What can I do to identify questionable pharmacy activity on a claim?
Pharmacy fraud represents one of the fastest-growing cost drivers in workers’ compensation claims. While most health care providers operate with integrity, fraudulent prescribing patterns can inflate claim costs by thousands of dollars, sometimes without adjusters noticing until significant damage has occurred.
Is generic Nucynta IR and ER a new option for treating injured employees?
Generic versions of Nucynta are now available in the U.S. market. For workers’ compensation claims, this may create brand-to-generic conversion opportunities, especially as part of a longer-term pain regimen.
Why do some medications need to be tried before others can be approved?
When you review a medication request, it’s not always clear why one drug is approved first and another is not. That is where step therapy comes in. In workers’ compensation, step therapy gives you a structured, evidence-based framework for evaluating medication requests, starting with well-supported, lower-risk treatments before moving to other options when medically necessary.
What is gabapentin and why is it so commonly prescribed?
Gabapentin was approved by the Food and Drug Administration (FDA) decades ago for seizures and nerve pain. Today, it is one of the most commonly prescribed drugs in the United States.
What emerging trends are influencing pain management approaches in workers’ compensation?
Pain management in workers’ compensation is continuing to shift as opioid prescribing declines and non-opioid alternatives gain traction. These changes reflect a growing emphasis on safety, function and evidence-based care, along with increased scrutiny of medication risk and cost.
What is Morphine Equivalent Dose and why does it matter in claims management?
Morphine Equivalent Dose (MED) is a standardized way to estimate a person's total opioid exposure over a 24-hour period. Because different opioid medications have varying potencies, a common measurement helps you compare “apples to apples.”
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Enabling adjusters and case managers to make educated decisions about drug therapy is a priority.
Our answer: Ask The Pharmacist. Just send an email by clicking the button below and our clinical team will attempt to answer your pressing questions about specific claims and offer clinical expertise to help you make decisions regarding drug-related issues.
workers' comp Pharmacy 101
Basics of Workers' Compensation Pharmacy Benefit Management
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Article Archive
Explore our collection of past articles.
- Are private-label topicals like Trubrexa worth the cost in workers’ comp?
- How do drug delivery choices affect pain, side effects, and time away from work?
- How do PCA pumps support pain management, reduce costs and speed recovery for injured employees?
- How can safer benzodiazepine tapering improve recovery?
- How can topical medications support pain management in workers’ compensation while balancing cost?
- How can CGRP therapies improve outcomes in workers’ compensation migraine claims?
- What role does adult vaccination play in workers' compensation claims?
- How serious is the threat of bird flu in North America?
- Does Journavx offer a safer alternative to opioids for acute pain relief in workers’ compensation?
- What is the role of buprenorphine in pain management for workers’ compensation?
- What are the management strategies for conditions like asthma and smoke inhalation injuries?
- What is tetanus and how can it be prevented?
- Could Cosentyx serve as an effective treatment option for chronic autoimmune conditions within workers’ compensation?
- What potential role does ketamine play in pain management for workers' compensation cases?
- What should I know about skeletal muscle relaxants in the treatment of injuries?
- How does storing medications ensure their safety and effectiveness until the expiration date?
- Will GLP-1 weight loss drugs become more prevalent in workers’ compensation?
- What are controlled substances and their regulations?
- Who should receive urine drug testing and how often?
- What are the different types of drug recalls?
- What are the advantages and limitations of topical vs. systemic pain medications?
- How does a P&T committee influence a workers' compensation pharmacy program?
- How does genetic testing enhance risk assessment for opioid use disorder (OUD)?
- Beyond convenience, are there advantages in the use of fixed-dose combination drug products?
- What are the various kinds of steroid medications?
- What is the difference between opioid addiction and dependence?
- What are the different types of opioid overdose reversal agents, and how do they compare?
- Could Ozempic be a potential breakthrough in addiction treatment?
- What are biological and biosimilar drugs?
- What implications does tobacco use have on medical treatment and the process of healing in workers’ compensation?
- What's the difference between a drug allergy and a side effect?
- When do drugs become generic?
- How does aging affect drug performance?
- Why would someone be prescribed an opioid to treat opioid addiction?
- Are there cardiovascular considerations related to common medications used in workers' comp?
- How are Prescription Drug Monitoring Programs used when managing or prescribing opioid medications?
- How are seizure drugs used for pain management in workers' comp?
- Are there rules or recommendations for traveling with a controlled substance?
- Are there rules or recommendations for opioid disposal?
- Are there times when it’s better to dispense a brand drug instead of its generic equivalent?