Clinical Resources

Workers’ Compensation Pharmaceuticals: Prior Authorization and High Dollar Rejections Guide

Workers’ Compensation Pharmaceuticals:  Prior Authorization and High Dollar Rejections Guide

The intent of this guidebook is to provide a resource for claims professionals that allows easy access to information on medications that have been rejected and that provides possible alternatives to the rejected medications. The guidebook also provides the most common indication for each medication when used in the workers’ compensation population.

A list of medications that should be considered prior to the rejected medication (step therapy) is presented, along with a supporting rationale.

Download »

Brand to Generic Reference Guide: Workers’ Compensation Pharmaceuticals

Brand to Generic Reference Guide: Workers’ Compensation Pharmaceuticals

This guide provides information on some of the most commonly prescribed medications in workers’ compensation. Included for each medication is the brand name and the availability of a generic equivalent. Some products may no longer be available as a result of discontinuations, and some new products may have been added after this guide was published.

This guide is not intended and should not be used nor relied upon for purposes of prescribing or using a product. It is solely for reference purposes. The trademarks and other product names listed in this guide are the property of their respective companies.

Download »

Workers’ Comp Mastery Training: How to Control Pharmacy Costs, Avoid Abuse and Deliver Pain Relief

Workers’ Comp Mastery Training: How to Control Pharmacy Costs, Avoid Abuse and Deliver Pain Relief

When used properly, prescription drugs can have a significant positive effect on injured workers by helping them recover and return to work as soon as possible. However, the issue is fraught with peril due to two powerful forces including misaligned financial incentives and potential misuse, abuse and addiction

This book outlines the strategies to control these negative forces to allow prescription medications to deliver positive outcomes. It covers three major areas including the role of the pharmacy benefits manager, controlling pharmacy cost drivers and taking a team approach between pharmacy benefits managers and third party carriers.

Download »