Keep Track of COVID-19 Developments

With new information coming out daily surrounding the COVID-19 pandemic, Healthesystems has created a developments page to track news related to impacts on the workers’ comp industry.

Articles surrounding clinical, regulatory, and industry developments are featured on this webpage and will continue to be posted here.

Click here to learn more.

Tags: COVID-19

FDA Approves Two Migraine Drugs and Two NSAIDs

New Migraine Drugs

The FDA has recently approved Nurtec ODT (rimegepant) orally disintegrating tablets for the acute treatment of migraine, as well as Vyepti (eptinezumab-jjmr) injections for the preventive treatment of migraines.

Nurtec ODT is a calcitonin gene-related peptide receptor antagonist for the acute treatment of migraines with or without aura and is not indicated for the preventive treatment of migraines.

According to the FDA-approved label, the recommended dose is 75 mg, taken orally as needed, and also serves as the maximum dose for a 24-hour period. The safety of treating more than 15 migraines in a 30-day period with Nurtec ODT has not been verified.

Adverse reactions include nausea, and Nurtec ODT should not be used in patients with severe hepatic impairment.

Vyepti is calcitonin gene-related peptide antagonist indicated for the preventive treatment of migraines. According to the FDA-approved drug label, Vyepti must be diluted prior to IV use, with a recommended dosage of 100 mg diluted in 100 mL of 0.9% Sodium Chloride Injection over 30 minutes, once every three months. The drug label notes that some patients may benefit from a 300 mg dosage.

Adverse reactions to Vyepti include nasopharyngitis (common cold) and hypersensitivity.


The FDA has also approved Anjeso (meloxicam) injection for intravenous use in the management of moderate-to-severe pain, alone or in combination with non-NSAID analgesics, as well as Advil Dual Action (ibuprofen; acetaminophen) tablets for the temporary relief of minor aches and pains.

According to the FDA-approved label, Anjeso should be administered once daily in a 30 mg bolus injection over 15 seconds. Because of delayed onset, Anjeso alone is not recommended for use when rapid onset of analgesia is required. Patients must be well hydrated prior to using Anjeso.

Advil Dual Action, an over-the-counter drug, is a new formulation that combines an NSAID with acetaminophen, and which can be used for the temporary relief of headache, backache, muscular aches, toothaches, menstrual cramps, and minor pain of arthritis.

According to the FDA-approved label, each tablet contains 250 mg of acetaminophen and 125 mg of ibuprofen. The directions recommend two tablets every eight hours while symptoms persist, recommending no more than six tablets every 24 hours.

This medication should not be used with other medications containing acetaminophen, as this can cause liver damage. Furthermore, combining this drug with alcohol increases the odds of liver damage.

Speaking to both Anjeso and Advil Dual Action, like any NSAID, these drugs cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction, and stroke, which can be fatal. NSAIDs are also known to cause increased risk of serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation of the stomach intestines, which can be fatal.

Tags: FDA, drug approval, Nurtec ODT, rimegepant, Vyepti, eptinezumab, migraine, NSAID, pain, Anjeso, meloxicam, Advil, Dual Action, ibuprofen

2020 Workers’ Comp Industry Insights Survey

For the second year in a row, Healthesystems collaborated with Risk & Insurance magazine to survey workers’ comp industry stakeholders regarding top challenges, program and population trends, health risks costs, and more.

Approximately 669 stakeholders responded to this survey, across various types of roles and organizations.

On a high level:

  • 70% of stakeholders report changing populations as a top industry challenge
  • 83% of stakeholders report complex claims require more clinical decision from claims management
  • 82% of stakeholders believe better claims efficiency will lower medical costs
  • 57% of stakeholders believe the top claim risk is a failure to detect early risk warning signs

For an in-depth look at the data, and what this means for the workers’ comp industry, click here to read the 2020 Workers’ Comp Industry Insights Survey.

Tags: Healthesystems, Industry Insights, survey, Risk & Insurance

JAMA Compares Effectiveness of Treatment Pathways for Opioid Use Disorder

The Journal of the American Medical Association (JAMA) recently published Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder. This study compared the effectiveness of six different treatment pathways across 40,885 adults with OUD, including:

  • Only non-intensive behavioral health (outpatient counseling) – which applied to 59.3% of patients
  • Inpatient detoxification or residential services – which applied to 15.8% of patients
  • Buprenorphine or methadone – which applied to 12.5% of patients
  • No treatment – which applied to 5.2% of patients
  • Intensive behavioral health, including intensive outpatient or partial hospitalization – which applied to 4.8% of patients
  • Naltrexone – which applied to 2.4% of patients

Primary outcomes included changes to overdose levels or serious opioid-related acute care use, defined as emergency department visits or hospitalization with a primary opioid diagnosis code. A secondary outcome was admission to detoxification or readmission for those who initiated treatment via inpatient detox.

All outcomes were evaluated three months and 12 months after treatment initiation.

The study found that individuals receiving buprenorphine or methadone were 76% less likely to experience an overdose within three months, and 59% less likely to overdose within 12 months. This cohort was also 32% less likely to experience serious opioid-related acute care within three months, and 26% less likely to experience serious opioid-related acute care within 12 months.

The study found that all other treatment groups were more likely to have a post-treatment admission to inpatient detoxification, citing established research that advocates for access to buprenorphine and methadone for OUD, while also exploring barriers to this care. According to this study, maintaining health insurance was challenging for patients, as 48.1% of patients were disenrolled within 12 months.

Approximately 53.8% of patients utilizing buprenorphine and methadone treatments were disenrolled within 12 months.

Tags: JAMA, buprenorphine, methadone, opioid use disorder, OUD, treatment pathway

Embracing Telehealth in Reaction to COVID-19

As the nation tries to practice social distancing to reduce the spread of coronavirus, workers’ comp is embracing telehealth to keep injured workers from unnecessarily going out and increasing their likelihood of exposure.

Many states have relaxed requirements for coverage of telehealth services to help increase access to needed medical care, including:

More states may likely follow suit soon, especially as the Center for Medicare and Medicaid Services (CMS) recently expanded access to telemedicine as well. Additionally, several state Medical Boards and Insurance Departments have suspended penalties or relaxed timelines for license renewals in order to permit impacted entities to prioritize services to consumers.

At this time, certain physical medicine vendors are expanding their telehealth service. MedRisk announced that they have broadened the scope of their telerehab services, while also broadening the scope of patients who qualify for telerehab.

Tags: Telehealth, COVID-19

Sandy Shtab Featured in IAIABC Member Spotlight

Every month, the International Association of Industrial Accidents Boards and Commissions (IAIABC), the largest trade association of workers’ comp jurisdictional agencies in North America, spotlights a key member, highlighting their experience and diving into what issues they feel face the workers’ comp industry.

This month, the IAIABC Member Spotlight features Sandy Shtab, Healthesystems AVP of Advocacy & Compliance. This member spotlight features Sandy’s point of view on how Healthesystems serves our industry, what she sees as major challenges and responses for workers’ comp, and more.

For this spotlight, Sandy Shtab delivered a video response. Click here to view this member spotlight in full.

Tags: Sandy Shtab, Healthesystems, IAIABC, spotlight, video