FDA Approves First Generic Naloxone Nasal Spray for Opioid Overdose

The FDA has approved the first generic naloxone hydrochloride nasal spray, commonly know by its brand name Narcan, a life-saving medication that can stop or reverse the effects of an opioid overdose, including potentially fatal respiratory depression, and which can be used by individuals without medical training.

While generic naloxone products have been available for years for use in healthcare settings, this is the first generic naloxone product that can be used by members of the public, as this product does not require assembly and delivers a consistent, measured dose when used as directed.

Use of naloxone nasal spray in patients who are opioid-dependent may result in severe opioid withdrawal characterized by body aches, diarrhea, increased heart rate (tachycardia), fever, runny nose, sneezing, goose bumps (piloerection), sweating, yawning, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, abdominal cramps, weakness and increased blood pressure.

The FDA is also planning new steps to prioritize the review of additional generic drug applications for products intended to treat opioid overdose, along with the previously announced action to help facilitate an over-the-counter naloxone product.

For more information, read the FDA News Release.

Tags: Naloxone, Narcan, nasal spray, overdose, opioid, opioid overdose, FDA, product approval, generic

2019 Workers’ Comp Industry Insights Survey

Healthesystems paired up with Risk & Insurance magazine to survey more than 500 workers’ comp professionals to weigh in on their top challenges, major trends, program priorities, and program successes for 2019 and beyond.

Survey respondent roles are broken down as follows:

  • Claims Management – 28%
  • Risk Management – 24%
  • Program Management – 11%
  • Cost Containment/Procurement – 9%
  • Legal/Regulatory – 5%
  • Medical Services – 3%
  • Other – 20%

The survey discloses how respondents overall felt about certain issues, while also breaking down responses by role type, revealing how the opinions of different stakeholders varied.

Download the survey today to learn more.

Tags: Healthesystems, Risk & Insurance, industry survey, survey, insights, industry insights survey, claims management, risk management

Negative Impacts of Combining Antidepressants with Opioids and Benzodiazepines

The Journal of Occupational and Environmental Medicine recently published Association of Opioid, Anti-depressant, and Benzodiazepines with Workers’ Compensation: A Cohort Study, which looks at 22,383 indemnity claims from 2008-2013 to evaluate the association of prescribed medications on claim cost and delayed claim closure.

Controlled for age, chronic pain, and other factors, the study found that the concurrent treatment of pain, depression or anxiety and occupational injuries are associated with large increases in claim costs and delayed return to work. These increases are specifically associated with the combination of antidepressants with opioids, or antidepressants with opioids and benzodiazepines.

According to the study, having antidepressants in a claim makes the claim 2.24x more likely to remain open, while having opioids in a claim leaves the claim 1.14x more likely to remain open, and benzodiazepines leaves a claim 1.38x more likely to remain open.

Claims without any of these medications had the highest closure rate of 91.8% with the lowest average claim cost of $19,604. However, the following drug regimens had lower closure rates and higher average costs:

  • Opioids had an 89.1% closure rate with an average claim cost of $28,563
  • Opioids and benzodiazepines had a 75.8% closure rate with an average claim cost of $53,366
  • Antidepressants and opioids had a 64.8% closure rate with an average claim cost of $64,507
  • Antidepressants, opioids, and benzodiazepines had the lowest closure rate at 58.3%, with the highest average claim cost at $93,367

While antidepressants appear to be linked to higher costs and lower closure rates, it is important to note that this study only looks at antidepressant use in combination with other powerful medications, and not by themselves.

Combining multiple drugs, known as polypharmacy, can often lead to increased risks due to drug-drug interactions, therapeutic duplication, and other concerns, especially when opioids and other powerful medications are involved.

Tags: Journal of Occupational and Environmental Medicine, JOEM, antidepressant, opioid, benzodiazepines, claim closure, average claim cost, polypharmacy

Growing Trend: Expanding Cancer Coverage for Firefighters

Florida Governor Rick DeSantis recently signed Senate Bill 426 into law, expanding workers’ comp benefits to firefighters diagnosed with 21 different types of work-related cancer, effective July 1, 2019.

In the line of duty, firefighters are often exposed to carcinogens as building material burns, putting them at risk of developing certain cancers over time. This new Florida law is only the most recent addition to a growing number of states expanding cancer coverage for firefighters in workers’ comp.

In April, Montana Senate Bill 160 was signed into law, expanding workers’ comp coverage to 11 types of cancers for firefighters, while Maryland House Bill 604 was signed to cover nine types of cancer for firefighters. In March, Virginia House Bill 1804 added three additional cancers to the list of occupational diseases covered for firefighters, which already included certain cancers.

Currently, North Carolina House Bill 520 now sits with the state Senate after having passed the House, potentially adding another state to the movement. This bill would add nine cancers to the list of covered occupational diseases, applying to both paid and volunteer firefighters.

These laws come with varying eligibility requirements; for example, Florida requires that firefighters serve at least five years and not have used tobacco products for five years in order to provide coverage, while Montana allows payers to not cover certain cancers if it is proven the disease did not develop as a result of firefighting.

As this trend continues to grow, workers’ comp programs must adapt to properly care for a higher number of cancer patients, requiring a greater understanding of oncology medications and perhaps other types of specialty pharmacy.

Furthermore, this trend continues to demonstrate the legislative priority that first responders are receiving in state chambers. Several states have passed laws to provide workers’ comp coverage for post-traumatic stress disorder (PTSD) in police officers, firefighters, and emergency medical workers, making the first responder population a group to watch; this segment of the workforce may continue to spur legislative change that could have a serious impact on comp.

Tags: Cancer, firefighter, first responder, Florida, Maryland, Montana, Virginia, North Carolina, PTSD

National Institute of Health to Launch $350 Million Opioid Intervention Study

The National Institute of Health (NIH), in partnership with the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), will soon launch the HEALing Communities Study, an initiative with more than $350 million in funding that aims to reduce opioid overdose deaths by 40% over three years in selected communities.

A series of proven opioid prevention and treatment interventions will be practiced, including the distribution of naloxone to reverse overdose and linking individuals in the criminal justice system with treatment for opioid addiction.

The study will track communities as they reduce the incidence of opioid use disorder, increase the number of individuals receiving medication assisted treatment for opioid use disorder, increase treatment duration beyond six months, and provide recovery support services for more individuals.

Furthermore, the study will generate evidence about how tools for preventing and treating opioid addiction are most effective at the local level, looking at the effectiveness of coordinated systems of care designed to reduce overdose fatalities and events.

The study will be carried out across four research sites, including:

  • University of Kentucky, Lexington
  • Boston Medical Center, Boston
  • Columbia University, New York City
  • Ohio State University, Columbus

Each site will partner with at least 15 communities to measure the impact of integrating evidence-based prevention, treatment, and recovery interventions across primary care, behavioral health, criminal justice and other settings in highly affected parts of the country.

An overview of the HEALing Communities Study can be found online, with information on which counties will be covered, as well as information on workshop meetings, research plans, and more.

RTI International, based in North Carolina, will serve as the study’s coordinating center, and will be responsible for data analysis, health economics research, and widespread dissemination of research findings over the course of the study.

Tags: National Institute of Health, opioid, NIH, SAMHSA, NIDA, overdose, naloxone, prevention, opioid use disorder, OUD