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Support for Formulary Widespread, Not Universal

  • State: California
  • Topic: Top
  • - Popular with: Employer
Elected officials, researchers, employers and others have come out in favor of implementing a p…

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4 Comments (2 Replies)

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Rhonda Wofford Nov 3, 2016 a 2:58 pm PDT

Why do we allow ourselves to be brainwashed by the mantra that "cost containment" is the greater good? The greater good should always be to "cure and/or relieve the effects of the industrial injury" as quickly as possible, Yes, if it is done correctly with the early and proper allocation of resources; then, money can be saved as a secondary benefit. The problem is that insurance carriers, and not just work comp carriers, live by the motto, "deny everything, when you can't deny; then delay; and when can't delay any longer; then, limit costs." That works well for preserving interest-earning cash reserves; however, it doesn't work well for producing positive medical outcomes.

Ultimately, the carriers will get what they because they are patient and will pay for it. So, let's support a reasonable formulary that as compromise doesn't require any UR approval as Mr. de la Torre suggested. It will provide quicker access to care and even give the carriers more "cost containment" by not having to pay for UR and IMR.

John De Vasure Nov 3, 2016 a 2:58 pm PDT

Let us go back to Labor Code section 4600 and provide reasonable and necessary medical treatment that is focused on the betterment of the injured worker's health. When IMR upholds a UR decision, is it not for the good of the injured worker? It sounds like many do not believe in the medical evidence that IMR uses to support their decisions.

Barbara Ramiller Nov 3, 2016 a 2:58 pm PDT

Just because you don't believe in it doesn't make it true. People didn't believe the world wasn't flat but it turned out they were wrong. People didn't believe in evolution but that has been proved to be correct as well. The idea of evidence based medicine is to provide reasonable and necessary medical treatment based on what medical evidence has proven to cure and relieve. Just because a doctor prescribes something that he has a financial interest in or because he wants to keep getting referrals from an attorney doesn't make it good medicine.

Anonymous Nov 21, 2016 a 6:49 pm PST

I have a very complex medical condition in which I take several medications off label. These medications were originally prescribed by a doctor at a major university after every other treatment was tried. It took years but I finally found something that allows me to somewhat have a life (previously I was living in bed due to pain). This type of legislation would absolutely hurt injured workers like myself.

John Kamin Nov 3, 2016 a 2:58 pm PDT

This appears to primarily target the fraudulent* compound medications that are overprescribed by so many doctors. It's good to see the owner of a compound pharmacy backing this bill.

*(See indictments, plea deals, etc.)

D C Nov 3, 2016 a 2:58 pm PDT

I think this is going after all medications, and not just the compounds. This would restrict off label use as well as force all to use generic medications. There is not always a generic for every medication and many cannot tolerate generic medications. It is also my understanding that they will change the guidelines which will prevent many from receiving proper medical treatment, especially for pain management. This is just another way to cut costs under a mask of deceit. California injured workers will be screwed, especially those who need pain control will medications.


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