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URINE DRUG TESTING & MONITORING For Workers’ Compensation NCCI Reports Pharmacy costs are 18% of the total medical spending in Worker’s Compensation Based on adherence studies… ► Less than 30% of claimants take their medications as prescribed ► More than 30% fill their medications but do not take them ► More than 30% take additional medications and/or substances that can reduce or eliminate the efficacy of the prescribed medications Urine Drug Testing and Monitoring can help determine exactly what medications are being ingested Adherence/Efficacy All individuals are different: Slow Metabolizers Fast Metabolizers Enzyme/Metabolizing Two enzymes metabolize the majority of opioids Inability to Metabolize ►Inhibitors ►Enzyme mutation Genetic Testing ►One test in a lifetime ►Determines individual’s metabolic rate ►Helps to create a more efficacious plan of care Types of Urine Drug Testing ►Point of Care Testing (POCT) ►Enzyme Immunoassay (EIA) ►Gas Chromatography/Mass Spectrometry (GC/MS) ►Ultra-Performance Liquid Chromatography/Tandem Mass Spectrometry (UPLC/MS/MS) Picking The Right Laboratory ►Laboratory chain of custody ►Reporting, scientific evidence? ►Knowledgeable clinical services department ►Technology ►Science Who Should Be Tested? ►Large drug spend ►Expensive and highly addictive drugs ►Extensive drug regimes ►Early refills, increase in dosage ►Settlement ►MSA Hurdles to Testing ►The treating physician… Uses POCT Uses a different lab Dispenses out of office Refuses to test ►Patient refuses QUESTIONS?