Pharmacy Question for the Week of April 6, 2020

Pharmacy Compliance Question of the Week


What is a lock-in program?


According to the white paper, “Healthcare Payer Strategies to Reduce the Harms of Opioids”:

“One strategy that has arisen from drug utilization reviews is the effective use of a lock-in approach to ensure that prescriptions are based on an informed view of the patient. Under a lock-in program, a patient chooses a single provider, a single pharmacy, or both. Payers only impose lock-in after less restrictive steps have been attempted that have been ineffective in curbing “doctor shopping” or the use of multiple, over-lapping prescriptions. Medicaid agencies in forty-eight states and the District of Columbia report having lock-in programs. These programs are intended to improve care coordination between providers and decrease diversion costs.(174) The program design of lock-in programs vary across states with respect to how to determine that patients are “locked-in,” the length of the program, and the restrictions of the program.”

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.