On March 31, 2021, the Official Disability Guidelines (ODG by MCG) announced changes to their published drug formulary status for several medications, including three skeletal muscle relaxants (SMR's) commonly prescribed in workers' compensation settings.
Chlorzoxazone (Parafon Forte), Metaxolone (Skelaxin) and Tizanidine (Zanaflex) are now assigned “N” status on the ODG formulary. The change from “Y” to “N” status for these may prompt utilization changes, favoring prescriptions for preferred (“Y” status) agents in the SMR category (or medications alternatives in other categories), especially in states that have formally implemented the ODG formulary. “Y” SMR's on the ODG formulary include baclofen (Lioresal), cyclobenzaprine (Flexeril), methocarbamol (Robaxin) and several others.
About ODG and “N” Drugs
The ODG by MCG medical treatment and return-to-work guidelines include a drug formulary that offers a model resource for states and managed care organizations supporting optimal drug utilization. The ODG Drug Formulary designates drugs that are preferred, first line treatments as “Y” and those that are not as “N” or not recommended as first line treatments for an illness or injury. States and payers that use the formulary may require prior authorization for any non-Y drug to define its medical necessity for an approved injury. The formulary is organized to allow ready evaluation of medications in a therapeutic category for their brand and generic names, generic and over-the- counter (OTC) availability, “Y” or “N” status and cost.
Impact to Your Formularies
Mitchell Pharmacy Solutions manages a standard and additional customized formularies to accommodate unique pharmaceutical care requirements of client organizations in diverse industries. Mitchell Pharmacy Solutions meets quarterly to review and update them with close consideration of the ODG and other expert formulary standards. Category reviews are completed on a scheduled and “as needed” basis to assess their alignment with current standards of practice and to assess impact of any changes across our client base.
Learn more about skeletal muscle relaxants and their role in workers' compensation.
For more information or any questions, please contact your client services manager.