Opioid safety program

We are dedicated to safer opioid drug doses

Sharp Health Plan is committed to reducing overuse and protecting patient safety. Effective January 1, 2017, Sharp Health Plan began an opioid cumulative dose program for members using opioid drugs.

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What is the opioid cumulative dose program?

The opioid cumulative dose program was created to reduce members’ likelihood of receiving unsafe levels of opioid medications.

Our program works by reviewing potentially unsafe levels of opioid medications. Examples of situations that can lead to unsafe levels of opioid medications are:  

  1. Receiving multiple prescriptions that contain opioids at the same time (drug overlap), or
  2. Receiving opioid prescriptions written by multiple prescribers, when one prescriber is unaware you are receiving an opioid from another prescriber.

Our goal is to help protect you from receiving unsafe and potentially harmful levels of medication.

How does it work?

This program only applies if you are receiving opioid drugs from two or more providers. If this is true for you, our clinical team will review your claims for those opioid prescription drugs. The

During a review, our team checks the morphine-equivalent dosing (MED) of your medications. An MED is an estimate of how many milligrams (mg) of morphine a medication contains, if the medication dose were converted to a similar dose of morphine. Finding the MED of your prescription claims helps us understand the level of potential harm of your opioid medications.

How will it affect me?

Depending on the MED level found in your prescription claims, either your pharmacy or your prescribing provider will need to take action. We’ve made it simple with the table below:

If your prescription claims from multiple providers show MED levels of:

> 90 mg MED

Your pharmacy will be asked to verify that the dosage is correct for your medications.

> 100 mg MED

Your prescribing provider will need to submit a prior authorization request and receive Plan approval in order for your medication to be covered.

We’re here to make sure you have access to the medications you need—we also want you to be safe. If you have any questions about the opioid cumulative dose program, please contact Customer Care at 1-858-499-8300 or toll-free at 1-800-359-2002.

Log in to Sharp Connect to learn about drug restrictions.