The Bureau of Workers’ Compensation has adopted the Work Loss Data Institute ODG® Drug Formulary (Appendix A) as the Drug Formulary for use in the workers’ compensation system. This allows for the review of certain medication prescribed to patients under workers’ compensation. It identifies some medications within certain classes to require approval prior to dispensing. These medications are listed as a status “N” in the formulary.
Medication listed as status “Y” or medications not listed may be dispensed without prior approval but may be subject to later review under certain circumstances.
The carrier or authorized pharmacy benefits manager will continue to make these determinations. These later reviews would not affect the drugs already dispensed but may affect future refills. No change in the present processes for prescribing, dispensing and review will occur until the dates listed below.
* For first prescriptions written and dispensed for the affected medications after January 1, 2016, the drug formulary will apply after August 28, 2016.
* For refills of medications with prescriptions written before January 1, 2016, the drug formulary will apply after February 28, 2017.
These notification periods allows all parties to become familiar with the formulary before any change in the present process will occur.