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Get to know your pharmacy benefits: STOP Opioid Program

Opioid abuse, misuse, and addiction is a rising epidemic across the United States. According to the National Survey on Drug Abuse and Health published in 2015, more than half of young adults misusing prescription opioids are getting them from family and friends, and personal prescriptions are one of the main sources of non-medical opioid abuse.

A number of states have taken the initiative to prevent over-prescribing of opioid prescriptions by limiting initial opioid prescriptions for acute pain to a short-term days supply. However, regulations and practices to prevent opioid abuse and misuse are not consistent across state lines.

That’s why we’ve introduced STOP. A key feature of BeRx pharmacy solution plans, STOP promotes safety and appropriateness before opioids are dispensed through improved drug utilization controls. The program ensures all members receiving opioid medications are not put at additional risk for addiction.

STOP is an advanced point-of-sale intervention focused on utilization management controls for opioids. STOP applies a hold on incoming claims that puts a member morphine equivalent dose per day (MED) equal to or exceeding a hard-stop threshold of 120 MED. An override will be allowed if exceeding the 120 MED threshold is medically necessary. In addition, STOP applies a soft-stop on incoming claims with cumulative lower MED threshold of 90 that can be overridden by the pharmacy after a drug utilization review.

 

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BeRx, from CHP, is a student-focused pharmacy benefits solution designed to meet the unique needs of the student population.

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