Healthcare Fraud Shield’s Latest Article: Treating the Side Effects of Opioid Use

5 Jun

Opioid abuse continues to be an overwhelming concern due to the propensity for individuals to become addicted.  Many SIUs work to make sure they are monitoring member use and prescribing trends for opioids, but less attention is placed on the treatment of the side effects of opioid use.  These side effects may include nausea, vomiting, drowsiness, and constipation.[1]  Constipation, while it may be an uncomfortable topic, is a real concern for many individuals.  Misuse of the medications treating side effects of opioids (also referred to as narcotics) can be cause for concern. 

Movantik

While there are several natural remedies for constipation, there are prescription antidotes for Opioid Induced Constipation (OIC)  .  One prescription drug approved for the treatment of OIC is Movantik (generic name naloxegol).  Movantik treats the constipation without reducing the pain-relieving effects of the narcotic.  According to the manufacturer, AstraZeneca, Movantik is for adults with chronic non-cancer pain and should be taken once daily.  Movantik is billed in either 12.5 mg or 25 mg tablets using the following NDCs:

  • 00310-1969-30
  • 00310-1969-39
  • 00310-1969-90
  • 00310-1970-30
  • 00310-1970-39
  • 00310-1970-90
  • 00310-1970-95 [2]

What to look for?

As always, check your organization’s internal policies prior to any review of claims.  See below for things to look for in your company’s claims data:

  • Movantik should only be taken if the patient is taking an opioid. If a patient discontinues opioid use, than Movantik is also discontinued.  Check each member’s recent prescription history to look for opioids. 

  • The Prescribing guidelines recommend that for maximum effectiveness, a patient be on opioids for at least 4 weeks prior to receiving Movantik.  Look at the initial fill dates of both the opioids and Movantik.

  • Check each member’s medical history to ensure diagnoses support appropriate use.

  • Review the frequency and length of time a member is being prescribed Movantik.

Using a tool such as RxShieldTM by Healthcare Fraud Shield can help with pharmacy analysis.  For more information, or if you have any questions or comments, please contact us at SIU@hcfraudshield.com.


[1] WebMD

[2] Movantik

If you have questions or comments, reach out to one of our subject matter experts at SIU@hcfraudshield.com.
If you would like to learn more about Healthcare Fraud Shield’s analytics solution, contact us at info@hcfraudshield.com.

                          
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