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Yet Another Price Drop for Oxycodone/APAP Tablets

Tuesday, December 10, 2019

Rizkallah_Nahla_cropped

Nahla Rizkallah, PharmD, MSCC

We previously shared a price update in August of regarding a widely used opioid-acetaminophen (oxycodone/APAP) combination product. Another price drop has been announced, and this time it is for all oxycodone/APAP tablet strengths, 5-325mg, 7.5-325mg and 10-325mg. This will significantly mitigate Part D allocation and save Workers’ Compensation payers money. The price drop is attributed to a reduction of the various strengths manufactured by Rhodes Pharmaceuticals, L.P., per CMS’ recognized and approved compendium, Red Book.

Table 1: Current Pricing Spectrum and Savings

Oxycodone/APAP strength

Previous lowest AWP

Current lowest AWP

~% Savings

5-325mg

$0.22

$0.18

18%

7.5-325mg

$0.70

$0.22

69%

10-325mg

$0.78

$0.25

68%

 

Table 2: August Pricing Schedule and 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%

 

According to the Official Disability Guidelines (ODG), of the patients who proceed to long-term opioid use of 90 days or more, two-thirds continue opioids for years, creating life-long therapy in some cases. The ODG does not recommend opioids as first-line in non-cancer pain. Results of studies suggest modest pain relief, approximately 30%, compared to placebo. 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. Opioid tolerance develops with repeated use of opioids and brings about the need to increase the dose and may lead to sensitization. It is now clear that analgesia may not occur with open-ended escalation of opioids. It has also become apparent that analgesia is not always sustained over time, and that pain may be improved with weaning of 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 opioid risk-benefit evaluation, potential opioid tapers, alternatives to high cost Medicare-covered medications, and clarification of 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. 

 

About Nahla Rizkallah, PharmD, MSCC

Nahla D. Rizkallah, PharmD, MSCC, serves as the Senior Clinical Pharmacist at ExamWorks Clinical Solutions. In this capacity, she performs prescription analysis to optimize drug therapy using evidence-based guidelines and national guidelines, and participates in physician outreaches to implement the recommendations. She has 29 years of experience in various area of pharmacy practice including: review of Part D medications on Medicare Set-Aside Allocations, prior authorization reviews for the Florida Medicaid program as Senior Clinical Pharmacist, development of drug utilization criteria, academic detailing, Pharmacy and Therapeutics Committee, Pharmacy Manager for a closed mental health facility, Pharmacy Manager for the indigent, staff/clinical pharmacist for assisted- living facilities (ALFs), medication audits for ALFs, drug information center, clinical pathways, staff education, and surgical/medical pharmacy satellite at All Children’s Hospital. Dr. Rizkallah has the following certifications: Medicare Set-Aside Certified Consultant, Hypertension and Dyslipidemias, and Diabetes. Dr. Rizkallah received her Doctorate from the University of Florida in Gainesville followed by a one year American Society of Health-System Pharmacists accredited residency.

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