Implementing Medication Assisted Treatment With Vivitrol

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1 Implementing Medication Assisted Treatment With Vivitrol Florida Systems Development Initiated 2006 RWJ Foundation Advancing Recovery Grant 1

2 Why Medication Assisted Treatment? Supported state strategic initiative: Increase consumer access to recovery and evidence based services and supports Potential impact on client outcomes: Florida provides substance abuse services to more than 160,000 individuals yearly. More than 40% indicate alcohol is primary drug of choice. Alcohol dependent detox admissions 24,000 annually. 2

3 Florida Advancing Recovery Partnership Department of Children and Families Substance Abuse Program Office Florida Alcohol and Drug Abuse Association (FADAA) State Pharmacy (Florida State Hospital) Provider Agencies: Operation Par ( ) River Region Human Services (2006-Present) Spectrum Programs (2006-Present) 3

4 Evolution The Florida Learning System The Florida Learning System was conceptualized 2006 The State pursued two grants to gain momentum (STAR-SI & AR) Initial Advisory Workgroup established as required by STAR-SI provided foundation for FLS First Meeting held in March 2008

5 Targeted Client Group Diagnosed alcohol dependent Multiple prior treatment failures Reported heavy drinking days Expressed motivation to change Met health requirements 5

6 Statewide Aim and Goal Aim Increase client retention in substance abuse treatment through the use of Vivitrol for the treatment of alcoholism. Goal/Direction Increase positive treatment outcomes through administering medication and appropriate psychosocial interventions. 6

7 Infrastructure Requirements Driven by regulations: Purchasing Pharmacy Storage delivery Specific Staff Credentials/Licensing Medication purchase Prescription Administration 7

8 Infrastructure Development Established capacity to purchase, store, and distribute medication Partnered with State Pharmacy Program Identified budget Indigent Drug Program Implemented a budget review and transfer process Implemented process to manage utilization of Vivitrol Developed utilization tracking system 8

9 Results Improved client outcomes Continuation of substance abuse treatment Increased independent living Improved employment and Decreased recidivism (2/3) Developed new partnerships Established infrastructure & process Expanded system capacity for MAT Began to demonstrate business case 64% decrease in cost compared to prior treatment 9

10 Results Reduced Number of Heavy Drinking Days Average Number of Heavy Drinking Days per Month/Injection (All Providers Three or More Consecutive Injections) Days First Second Third Fourth Fifth Sixth Average Drinking Days # of Clients Injection Number 10

11 Results Client Outcomes Reduced Number of Heavy Drinking Days 11

12 Results Clients Receiving Vivitrol Report Reduced Urge to Drink 12

13 Results Clients Reported Increased Motivation to Quit Drinking 13

14 Results Reduced Average Number of Admissions 14

15 Client Cost Comparison info being updated 15

16 16

17 Results Established State Processes Guidelines to approve provider agencies to access medications through the State Pharmacy Medication purchase and distribution procedure Budget management Determine capacity to offer MAT at provider level 17

18 Barriers/Challenges Prohibitive costs of medication Limited funding for medications Current economic climate Vivitrol not on the Medicaid Formulary Recently reviewed for Preferred Drug List - denied Limited opportunities for Medicaid billing 18

19 Program Expansion/Current Status Surveyed providers to determine interest 2009 Spread to include new agencies Southwest Florida Addictions Services (SWFAS) Meridian Behavioral Healthcare Maintained financial support Continue to offer Vivitrol at selected sites Continue to evaluate cost effectiveness and opportunities for expansion 19

20 Connections w Primary Health Care Establish Linkages MOU with local healthcare agencies, SBIRT Contractual requirements introduced FQHC Established onsite primary healthcare services Purchasing exploring options- FQHC 20

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