New Opioid Drug Safety Edits Coming In 2018

New Opioid Drug Safety

Beginning Jan. 1, 2018, Humana Pharmacy Solutions will implement several point-of-sale edits to assist in addressing safety concerns regarding opioid prescriptions.

The 2018 drug safety edits will apply when:

  • The cumulative opioid threshold exceeds 250 mg morphine equivalent dose (MED) – Prior authorization will be required.
  • Multiple prescribers and multiple pharmacies are used to obtain the same or similar opioids – Prior authorization will be required.
  • The opioid threshold dose is between 100 mg and 250 mg MED – Dispensing pharmacist will evaluate for appropriate use.
  • Concurrent opioid use with benzodiazepines (double threat) – Dispensing pharmacist will evaluate for appropriate use.
  • Concurrent use of opioids, benzodiazepines and muscle relaxants (triple threat) – Prescriber will receive alerts to consider alternate therapies.

Patients may have multiple health conditions and more than one prescriber. In some cases, prescribers may not be aware of other treatments, which is problematic. The safety edits are designed to bring awareness to such situations.

Questions can be directed to Humana’s Retrospective Drug Utilization Review team at
1-877-222-0589. An associate will return all calls.