Controlled substances

Prime has been a leader on controlled substances misuse for more than a decade. Our program combines existing and new services to help address this national epidemic.

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CS Score

Model reduces risk

Opioid misuse and over-prescription continues to be a major issue in the U.S. Our experience taught us that a multi-pronged model is the most effective way to fight this epidemic.

In addition to our current controlled substance efforts, we created a controlled substance management program. One of the highlights is a controlled substance score. It identifies people at risk of controlled substance misuse through predictive modeling.

The score is calculated by evaluating the:

  • Number of unique controlled substance claims
  • Total unique pharmacies and prescribers
  • Utilization rate over time

This score then is used with our GuidedHealth® rules engine, which identifies drug therapy opportunities and encourages doctors to target and prioritize interventions.

More about our controlled substance score

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More about our thought leadership

Stories

July 31, 2019

Prime showcases its controlled substance work at national conference

The 2019 Rx Drug Abuse & Heroin Summit held this past April in…

Perspectives, Stories

April 21, 2020

Driving Medicaid dollars to do more

Today, more than 70 million Americans are enrolled in Medicaid plans.¹ Medicaid represents…

Perspectives

June 15, 2018

Reducing opioid use among outliers; are we doing enough?

Prime has achieved a 79 percent decline in high-risk opioid outliers over five…

Perspectives

November 30, 2017

Study of short-acting, long-acting and abuse-deterrent opioid use

What was the study about? With opioid use and abuse continuing to rise,…