Pain management continues to be a serious concern for managed care providers considering the large population of individuals experiencing pain. Generally, pain can be categorized as either acute or chronic. Acute pain is considered the normal, predicted, physiological response to an adverse chemical, thermal, or mechanical stimulus, which is usually associated with surgery, trauma, or an acute illness.
The etiology of chronic pain is poorly understood; it is thought that exposure to noxious stimuli initiates a cascade of events that sensitizes the nervous system, both centrally and peripherally, to future stimuli, resulting in an intensified perception of pain. An estimated 76.5 million Americans suffer from pain.
According to the survey, 32.5% of respondents have greater than 35,000 covered lives that are affected by pain management.
When asked if they had any branded pain management agents available on a preferred copay tier, such as tier 2, 67.5% of the survey panel answered “yes.” As for pharmacy management programs in place to manage drugs in this class, 75% of the survey panel said they have programs in place. When asked to elaborate on what types of programs they currently have in place, the respondents provided the following answers: 60% said they utilize prior authorization on some agents; 50% said they utilize quality level limits on all agents; 37.5% said they utilize quality level limits on some agents; and 40% said they utilize step therapy.
A majority of respondents (82.5%) said they do not treat “abuse resistant” products as preferred agents. In terms of utilizing polypharmacy edits, 85% of respondents answered “yes.”