WCB is making changes to prescription drug formularies for injured workers
On May 11, 2015, the WCB changed our prescription drug formularies to help ensure injured workers have access to the drugs that will effectively support recovery and return to work, at the right times and in safe amounts. These changes will introduce a new Special Authorization process, which will be administered via a partnership with Medavie Blue Cross.
Opioids were moved into their own time-limited formularies: one for acute injuries and one for more critical injuries or illnesses (see opioid guide). Many non-opioid medications were also moved from open benefit to special authorization status (see non-opioid guide).
All prescribers and pharmacies have been mailed a toolkit that includes details on these important changes. By following the links below, you will find up-to-date forms and information referenced in the toolkit:
Most injuries (such as musculoskeletal, bones/nerves/spinal cord, wounds, burns, other traumatic injuries) will have automatic coverage for many opioids for 12 weeks following the date of injury. More critical illnesses (cancer) or injuries will have automatic coverage for opioids for 24 weeks following the date of injury.
In addition, there will be quantity limits introduced for certain drugs to support medically safe dosage levels.
All injuries which occur on or after May 11, 2015 will be subject to the new prescription process and quantity limits for both opioids and non-opioids.
For those workers with an open WCB claim whose injury occurred before the effective date current coverage will remain in place for prescriptions. If an injured worker presently has opioid coverage, the same level of opioid coverage will be maintained, and the time limited access will not be enforced. Existing injured workers will also continue to receive coverage for any non-opioids they currently receive. When the formulary changes come into effect, it is only when a new non-opiod or product is prescribed (i.e. not filled within the last 12 months) outside of the injured worker’s formulary that Special Authorization will be required.
Nova Scotia’s Chief Medical Examiner, Dr. Matt Bowes, agrees with the changes, stating, “The abuse of prescription drugs is a serious problem in Nova Scotia, and the solution will require many agencies working together for the public good. I applaud the WCB’s continuing efforts to align its practice with current evidence.”
“Good prescribing is informed by evidence and fortified by assessment and reassessment of the patient,” said Dr. Gus Grant, Registrar and CEO at the CPSNS. “The changes made by the WCB align the formularies with best practices and supports good prescribing.”
Limits and criteria around drug coverage and the new process align with best practice and the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain, which are endorsed by the Canadian Medical Association and College of Physicians and Surgeons of Nova Scotia.