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NEWS FLASH – Price Drop for oxycodone/APAP 7.5-325mg and 10-325mg!

Monday, August 12, 2019

A widely used opioid-acetaminophen combination product, oxycodone/APAP 7.5-325mg and 10-325mg, has seen a significant drop in price! This will dramatically mitigate the Part D allocation and could save Workers’ Compensation payers money. The price drop is attributed to a new product manufactured by Eywa Pharma Inc, per CMS’ recognized and approved compendium, Red Book.

The table below outlines the previous lowest Average Wholesale Price (AWP), the current AWP and the approximate percentage in savings.

Oxycodone/APAP strength

Previous lowest AWP

Current lowest AWP

~% Savings

7.5-325mg

$2.57

$0.70

73%

10-325mg

$3.37

$0.78

77%

An example of the potential savings in a patient on oxycodone/APAP 10mg-325mg three times daily as needed (#90 per month), with a 28 year life expectancy, would equate to $23,587.20, down from$101,908.80; affording $78,321.60 in hard dollar savings.

The Official Disability Guidelines do not recommend opioids as first-line in non-cancer pain. The National Council on Compensation Insurance states that high use of opioids in the first quarter following injury indicates a higher than average probability of opioid use in subsequent periods. There is fairly good evidence that increased opioid use is associated with decreased function, increased medical cost, lower return-to work rates, increased claim duration,  and increased costs. The good news is opioid utilization and the associated spend is on the decline! The Workers Compensation Research Institute (WCRI) latest report on Interstate Variations on Dispensing Opioids noted the volumes of opioids dispensed decreased, reduced morphine equivalent dosage (MED), and a decrease in the percentage of patients prescribed opioids.

Best practices focus on improved patient functionality and clinical outcomes, increased safety and decreasing migration from acute use of opioids to chronic use. The importance of early intervention and monitoring is paramount!

ExamWorks Clinical Solutions Doctors of Pharmacy offer alternatives to high cost Medicare-covered medications and clarify drug regimens to provide the most accurate and defensible MSA. The goal of the program is to impact medication therapy and mitigate MSA drug costs by consulting with the treating provider on the clinical rationale. ExamWorks utilizes technology and compendia databases which are recognized and supported by the CMS to support inclusion or exclusion of a drug under the Part D benefit. We will continue to monitor changes in medication pricing as well as availability of generic equivalents within the marketplace. 

For questions about medications or the ExamWorks Clinical Solutions Pharmacy programs, please contact Nahla D. Rizkallah, PharmD at 678.256.5086 or nahla.rizkallah@examworks-cs.com