Multiple Companies Recall Ranitidine Hydrochloride Due to Contamination

Back in September, Sandoz Inc. voluntarily recalled all quantities and lots within expiry of ranitidine hydrochloride capsules because of confirmed contamination with N-Nitrosodimethylamine (NDMA), a probable human carcinogen, above levels established by the FDA.

Ranitidine hydrochloride capsules are indicated for the treatment of duodenal ulcer, benign ulcer, reflux esophagitis, post-operative peptic ulcer, Zollinger-Ellison Syndrome, and other conditions where reduction of gastric secretion and acid output is desirable.

Relevant to workers’ comp, patients taking opioid pain medications may experience gastrointestinal side effects, requiring a gastrointestinal agent and potentially being prescribed ranitidine hydrochloride.

While this initial recall from Sandoz impacted 14 lots ranging from 30-500 count bottles, more recalls have since been initiated in October.

Sanofi has issued a recall for all Zantac OTC (ranitidine hydrochloride) in the U.S., Perrigo is recalling all ranitidine hydrochloride worldwide, and Dr. Reddy’s is recalling ranitidine hydrochloride nationwide. All of these recalls are based around similar concerns of contamination surrounding NDMA.


Tags: FDA, recall, ranitidine hydrochloride, ranitidine, contamination, gastrointestinal, GI


Clearing the Air: Marijuana Considerations for Workers’ Comp

Public support for marijuana is at an all-time high. What does this mean for workers’ comp?

Healthesystems has published a new white paper that explores when marijuana could appear in a claim, how legislation dictates marijuana use, what the clinical science has to say, workplace safety points to consider, and the role PBMs can play.

Click here to read the white paper.


Tags: marijuana, medical marijuana, white paper, Healthesystems


Social Determinants of Health

PwC’s Health Research Institute (HRI) recently published Social Determinants of Health, a report that examines how social factors such as employment, housing, education and transportation can undermine healthcare best practices.

This report utilizes many of PWC’s resources, including a global June 2019 survey of 8,000 people across eight countries, along with interviews with healthcare organization leaders, and an analysis of more than 20 case studies to address social determinants of health.

Despite increases to life expectancy, healthcare spending, and improved health outcomes, chronic health conditions such as obesity continue to rise, putting large portions of the population at risk for more serious chronic conditions like diabetes and cardiovascular disease.

It is estimated that 80% of a person’s health is attributable to health behaviors related to their physical environment and socioeconomic conditions, and so it is important that various healthcare stakeholders consider social determinants in the course of care.

According to the survey component of this report:

  • 35% of respondents cited a lack of sleep as a top impediment to a healthy lifestyle
  • 26% of respondents said too much time with technology prevented healthy habits
  • 20% of respondents could not afford aspects of a healthy lifestyle, such as healthy food and gym memberships

In highlighting societal factors that determine health, the study found an interesting split between different developed nations. The U.S. currently has a 66% obesity rate, while Japan had a 26% rate. While there are likely many cultural differences that result in such different obesity rates, the study states that in the U.S., per capita sugar consumption is almost twice that of Japan.

More research is needed to better identify what specific social determinants have the greatest impact on care, and which can be best utilized in workers’ comp, but this report offers five steps to approach healthcare from a more socially conscious route. These steps include:

  • Building collective will to address social determinants of care among various stakeholders
  • Developing standard but adaptable frameworks so health coalition partners can align efforts
  • Generating data insights to inform decision making
  • Engaging and reflecting the community
  • Measuring and redeploying strategies

For further information, read the report in full.


Tags: PWC, social factors, social determinants, socioeconomic


California Gig Law to Reclassify Contractors as Employees

California Assembly Bill 5 has been enacted into law, establishing a test to clarify if a worker should be classified as an independent contractor or an employee entitled to benefits such as minimum wage, health insurance, and workers’ comp.

Reflecting sentiments expressed in Dynamex Operations West, Inc. v Superior Court of Los Angeles (2018), a recent California Supreme Court case, the bill codifies the “ABC” test which establishes that a person providing labor or services for remuneration shall be considered an employee rather than an independent contractor, unless the hiring entity demonstrates that all of the following conditions are satisfied:

  • The person is free from the control and direction of the hiring entity in connection with the performance of the work, both under the contract for the performance of the work and in fact
  • The person performs work that is outside the usual course of the hiring entity’s business
  • The person is customarily engaged in an independently established trade, occupation, or business of the same nature as that involved in the work performed

This law is expected to reclassify a significant number of gig positions in the state to employee positions, and with this change would come great financial ramifications. The California Department of Industrial Relations claims that employee misclassification was responsible for $7 billion in lost payroll tax revenue to the state.

Some have argued that this law could eviscerate the gig economy as it impacts companies like Uber, Lyft, Postmates, Amazon and DoorDash. But while the impact of this law is expected to be large, it excludes various professions, including physicians and other licensed medical professionals, attorneys, financial planners, brokers and accountants, insurance agents, realtors, hairstylists, freelance writers and even some owner/operator truckers.


Tags: gig economy, contractor, independent contractor, employee, employee misclassification, California, ABC test, benefits


Healthesystems at NWCDC 2019

Healthesystems will be attending and exhibiting at NWCDC 2019, the largest annual conference in the workers’ comp industry, and we invite you to join us in Las Vegas for various educational opportunities.

Visit Healthesystems at Booth #1922

Come learn how Healthesystems is transforming healthcare with our pharmacy and ancillary benefits management programs. Conference attendees can also pick up a copy of RxInformer clinical journal. The new, Winter 2019/2020 edition is a special pricing issue with articles and infographics that cover hot topics such as:

  • Rising drug prices and the impact on workers’ comp costs
  • A looming physician shortage that could impact the delivery of care
  • Understanding how fee schedules are set for medical equipment and services, and how to scrutinize those costs
  • Tips claims professionals can utilize to keep patients safe and prevent costly complications
  • How more dynamic data in physical medicine programs can empower decision making and improve claims outcomes
  • And more

Medical and Pharmacy Insights for a Successful Return to Work

Healthesystems’ VP of Clinical Services, Silvia Sacalis, BS, PharmD, will cohost Medical and Pharmacy Insights for a Successful Return to Work with The Hartford’s Chief Medical Officer, Adam Seidner, MD, MPH.

This educational presentation will discuss policies and procedures that can help employers and providers make safe return-to-work recommendations for injured workers. Drs. Sacalis and Seidner will go over accessing analytic tools and developing programs for evaluating fitness-for-duty and navigating prescription medications to avoid negatively impacting functional abilities.

The presentation will take place at 3:00 PM on Thursday, November 7th in the South Pacific F room.

Workers’ Comp Industry Insights Survey

Healthesystems is teaming with Risk & Insurance magazine to conduct an industry insights survey. Workers’ comp professionals are invited to visit booth #1025 to answer questions and engage in discussion with Risk & Insurance editors surrounding their biggest industry concerns, challenges and successes.

Upon completion and analysis of the results, Healthesystems will publish its annual industry insights survey in early 2020.


Tags: Healthesystems, NWCDC, NWCDC 2019, RxInformer, educational presentation, panel, Silvia Sacalis, survey, industry insights survey, Risk & Insurance