The panel discussion focused on how workers' compensation formularies can reduce opioid prescriptions. Formularies in states like Texas, Ohio, Oklahoma, and Washington were examined. The panel identified best practices for designing and implementing an effective formulary, and discussed stakeholders affected by formularies. Key factors in Texas' successful formulary were identified, as were lessons that can be learned from other states' experiences. The discussion addressed challenges like treating chronic pain if opioids are prescribed less and managing "legacy claims."

1. Panel Discussion:
Using Workers’ Compensation
Formularies to Reduce Rx Opioids
Presenters:
• Joseph Paduda, MS, Principal, Health Strategy Associates
• Mark Pew, Senior Vice President, PRIUM
Third-Party Payer Track
Moderator:
• Michelle C. Landers, JD, Executive Vice President
and General Counsel, Kentucky Employers’
Mutual Insurance, and Member, Rx and Heroin
Summit National Advisory Board

2. Disclosures
Joseph Paduda, MS; Mark Pew; and Michelle C.
Landers, JD, have disclosed no relevant, real, or
apparent personal or professional financial
relationships with proprietary entities that
produce healthcare goods and services.

3. Disclosures
• All planners/managers hereby state that they or their
spouse/life partner do not have any financial
relationships or relationships to products or devices
with any commercial interest related to the content of
this activity of any amount during the past 12 months.
• The following planners/managers have the following to
disclose:
– John J. Dreyzehner, MD, MPH, FACOEM – Ownership
interest: Starfish Health (spouse)
– Robert DuPont – Employment: Bensinger, DuPont &
Associates-Prescription Drug Research Center

4. Learning Objectives
1. Explain how workers’ compensation formularies
reduce opioid prescriptions.
2. Describe the operations and outcomes of
formularies in such states as Texas, Ohio,
Oklahoma and Washington.
3. Identify best practices for designing and
implementing a workers’ compensation
formulary.
4. Provide accurate and appropriate counsel as
part of the treatment team.

5. Panel Questions
• Describe a Commercial drug formulary in 10
words or less.

6. Panel Questions
• Describe a Commercial drug formulary in 10
words or less.
• Describe a Workers Compensation drug
formulary in 10 words or less.

7. Panel Questions
• Describe a Commercial drug formulary in 10
words or less.
• Describe a Workers Compensation drug
formulary in 10 words or less.
• How and why are the two different?

8. Panel Questions
• Where do formularies “fit in” to the overall
medical and claims management process?

9. Panel Questions
• What’s the better approach – drug specific or
condition/disease state?

10. Panel Questions
• Why do we need formularies in Work Comp?

11. Panel Questions
• Identify the top three “guiding principles” for
a successful Work Comp drug formulary.

12. Panel Questions
• What is THE outcome that would demonstrate
success?

13. Panel Questions
• Who are the stakeholders affected by
formularies and the formulary process? How
do the different types of formularies address
their needs or change their processes?

14. Panel Questions
• What did Texas do right with their Work Comp
drug formulary and related programs?

15. Panel Questions
• What did Texas do right with their Work Comp
drug formulary and related programs?
• What did Texas do wrong with their Work
Comp drug formulary and related programs?

16. Panel Questions
• What can non-monopolistic states learn
anything from Ohio and/or Washington?

17. Panel Questions
• Will Tennessee’s new drug formulary be a
success?

18. Panel Questions
• If opioids are prescribed less, how is chronic
pain treated?

19. Panel Questions
• Is it really that tough to address “legacy
claims”?

20. Panel Questions
• Are pharmacy benefit managers just a
commodity with a state-mandated drug
formulary?

21. Panel Discussion:
Using Workers’ Compensation
Formularies to Reduce Rx Opioids
Presenters:
• Joseph Paduda, MS, Principal, Health Strategy Associates
• Mark Pew, Senior Vice President, PRIUM
Third-Party Payer Track
Moderator:
• Michelle C. Landers, JD, Executive Vice President
and General Counsel, Kentucky Employers’
Mutual Insurance, and Member, Rx and Heroin
Summit National Advisory Board