Westerville, OH – Progressive Medical, Inc., a workers’ compensation pharmacy benefit manager (PBM) and ancillary services provider, recently announced the release of its 2013 Workers’ Compensation Drug Trend Report. The annual report helps payors understand what trends in prescription medication spending mean to their organizations and showcases the performance of the company’s book of business and the value its programs deliver to clients.
Key highlights from the 2013 Drug Trend Report include:
- Overcoming inflation in average wholesale price (AWP) of 5.5%, the company reduced the overall number of prescriptions per claim by 2.0% and decreased days’ supply per prescription by 0.8% while product and claim mix further augmented savings by 3.2%. The net impact was a 0.5% overall reduction in medication spend.
- Network efficiencies derived from the company’s affiliation with StoneRiver Pharmacy Solutions (SRPS) continue to have a positive impact on control, utilization and spend as the company once again achieved up to 98% retail pharmacy network penetration. The real-time integration of proprietary Medication Plans, drug utilization review edits and common eligibility criteria at the point of sale is driving additional cost reductions and helping to ensure that the injured worker receives the right drug at the right time.
- The use of advanced analytics techniques to predict potential high-cost, high-risk claims, along with the use of a patent-pending statistical model to guide clinical decision making, is reaping significant benefits for payors and injured workers alike. Results of the early intervention program launched last July reveal a 15% reduction in morphine equivalence per claim and a 36.9% reduction in the prescription cost per claim just two months after intervention.
- As further evidence of its positive influence on cost and utilization, the company reports more claims are closing in the acute phase. Its total program solution results in a 51% decrease in the likelihood that a claim will mature into a two-year claim. In addition, as a percentage of total prescription volume, use of long-acting and immediate-release opioid analgesics is down while use of anti-inflammatory medications, anticonvulsant and antidepressant medications is either flat or up.
- Through its expertise in government affairs, Progressive Medical has been instrumental in shaping policy that addresses many of the external influences impacting industry payors. In addition to being actively engaged in legislative matters regarding physician dispensing, repackaged medication reimbursement, workers’ compensation reform and the opioid epidemic, among others, the company routinely guides clients through regulatory implementations and educates policy makers on the implication of legislation on the industry.
Emry Sisson and Tommy Young, co-chief executive officers, commented: “Our results demonstrate that the combination of our network, utilization management and proactive clinical programs is effectively reducing costs, diminishing out-of-network hassles, streamlining claim processes and increasing workflow efficiencies. Augmented by the use of advanced analytic insight to proactively intervene when clinically appropriate, we definitively show that we can positively impact pharmacy spending. It’s very exciting to see our vision in motion, as these results demonstrate our company’s dynamic ability to truly help our clients gain more control and achieve better outcomes.”
The complete report is available here: Progressive Medical 2013 Drug Trend Report
Source: Progressive Medical