National Business Group on Health issues new recommendations for pushing PBMs on opioids

Employers should take a more active role in working with insurers and pharmacy benefit managers to help curb potential opioid misuse among their workers, according to new recommendations from the National Business Group on Health (NBGH).

Released on Wednesday, the NBGH recommendations include working with insurers and PBMs to assure they are implementing national guidelines for prescribing opioids. The Centers for Disease Control and Prevention released the guidelines more than two years ago recommending certain dosage, duration and follow-up.

"It's also ensuring they're following prescribing patterns to the extent they can but also looking at plan design and how things are being managed overall," Brian Marcotte, president and CEO of the NGBH told FierceHealthcare in an interview. The NBGH is a D.C.-based nonprofit representing more than 420 large U.S. employers. 

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Specifically, employers should be ensuring their insurers and PBMs are identifying prescribers who have prescribing habits that are out of the norm, addressing those habits and instituting limits on opioid prescriptions for acute pain to short durations. They should also be educating and incentivizing physicians to prescribe immediate-release opioids when starting therapy for chronic pain instead of extended-release or long-acting opioids, choosing the lowest effective dose when prescribing opioids and avoiding concurrent prescribing of opioids and benzodiazepines whenever possible.

Employers should also seek to ensure their plan design covers alternatives to opioids when it comes to pain management.