Opana ER will be voluntarily removed from the marketplace, per the announcement last week of manufacturer Endo International plc. This follows the FDA’s suggestion that we blogged about last month—and it is an important next step in the fight against opioid abuse.
No date has been set to remove the medication, but we’re closely monitoring the REDBOOK AWP price list for the Opana ER National Drug Code (NDC).
Immediate Effects on WCMSAs
The Centers for Medicare and Medicaid Services (CMS) policy and process won’t exclude the medication from Workers’ Compensation Medicare Set-Asides (WCMSAs) until the NDC code is officially deleted. If parties want to proactively calculate the cost of excluding Opana ER, we recommend holding off on CMS submission of the WCMSA until the NDC removal is complete.
Ideally, Endo’s announcement to remove Opana ER will influence prescribers to proactively switch their patients from Opana ER to a different and less expensive pain medication. That could allow parties to reduce the WCMSA amount before the Opana ER NDC is removed.
If you have questions about Opana ER or WCMSAs, please feel free to e-mail Sid Wong at Sidney.Wong@verisk.com.