by Justin Leader
justindleader@gmail.com
For the better part of my career I have been analyzing various aspects of healthcare, prescription drug utilization and claims. One employee benefit that I understand thoroughly is Accidental Death and Dismemberment. Whether it be employer provided basic, voluntary or business travel accident, I have seen a multitude of claims over the years. Some of these preventable, some not, with all of them being tragic.
For the longest time I have come to see automobile accidents, workplace mishaps, acts of God and other events like these as the primary cause of accidental death. I have to tell you that in the course of the past week, I was overwhelmed by the amount of information that flooded into me regarding the new and rising number one cause of accidental death in the state of Pennsylvania; Overdose caused by Opiate abuse.
In 2003 I had received a call from my childhood best friend. He called to regretfully inform me that one of our High School friends, one who I greatly admired, Shaston Hillegass, had passed away accidentally from ingesting OxyContin. This was the first time I had ever heard of the drug but it would not be the last for any of us. I was a sophomore in college at the time and by my senior year I personally knew many individuals struggling with addiction, many who confided in my as their Resident Assistant. Sadly, I have seen many more lives ruined as well as individuals that have died as I entered into adulthood. One of which was a rising star of an ER doctor who became addicted and subsequently lost his medical license after more than a decade of hard work. Sadly this extremely intelligent human being is serving a long sentence in a federal prison.
“Addiction is a family disease… One person may use, but the whole family suffers.”
Having began my career in the Pharmaceutical industry, I know firsthand the way in which drugs are marketed to the medical community as well as direct to consumer. When OxyContin was released in 1996, it was marketed as having lower abuse potential than immediate-release oxycodone because of its time-release properties even though there was no scientific evidence backing that conclusion. It should come as no surprise that in the initial launch 5000 professionals of the medical community were wine and dined with sales reps and speaking promotions. Sales grew from $48 million in 1996 to almost $1.1 billion in 2000. Through the sales representatives, Purdue used a patient starter coupon program for OxyContin that provided patients with a free limited-time prescription for a 7- to 30-day supply. By 2001, when the marketing program was ended, approximately 34,000 coupons had been redeemed nationally.
Last week when politician Josh Shapiro stated “Overdosing, is now the number one accidental killer in our Commonwealth”, a lump formed in my throat thinking about my friends that I have lost since Shaston, as well as the number of lives that have been impacted by this epidemic. In Pennsylvania 3500 people died last year from overdose, well above the 2400 in 2014. According to PennDOT, 1,195 were killed as a result of a motor vehicle crash in Pennsylvania in 2014, and the 2014 total of reportable traffic crashes is the fourth lowest total since 1950.
There are a number of initiatives underway to help curb this epidemic not only within our state but also nationally. My question is, what can we do to help stop addiction or identify it when it occurs? As employers and broker/consultants of health and RX plans, there are certain steps we can take. We must all keep in mind that drug seekers will often find a way to get drugs however we can help to identify problems perhaps before it becomes rampant. Once such was in in medication therapy management and oversight of drug programs.
In analyzing RX and Health claims data, we can identify people that are getting far more scripts than recommended. Recently we performed an audit for a large county government quickly identifying that there was in fact a problem. This identification allows for the effective communication to the population regarding the dangers of drug abuse as well as allowed an opportunity for intervention via assistance provided through the employer’s EAP program. We are finding that education on the issue is of the utmost importance. Whether it be the C-Suite or the part time employee on the work floor addiction can affect anyone at any time.
While there is no one clear cut solution to the problem of opiate abuse and subsequent overdose, I feel that it is our responsibility as a community to take action.