May 23, 2018

Coventry WCS/First Script 2012 Trend Analysis: Workers’ Comp Drug Spend is on the Decline

Franklin, TN – Coventry Workers’ Comp Services recently released their First Script 2012 Pharmacy Trend Analysis: Despite significant outside influences on the cost of prescriptions, First Script’s clients experienced a 5.3% decrease in drug utilization due to our management programs. In fact, looking at a subset of data for years one through ten we saw a decrease in spend of 15%. This, among other trends, proving valuable insight into the workers’ comp industry, are outlined in the 2012 Pharmacy Trend Analysis published by Coventry Workers’ Comp Services (Coventry).

The role of a Pharmacy Benefit Manager (PBM) in workers’ compensation has evolved in response to new dispensing practices and a growing recognition that all pharmacy utilization – not just that which is dispensed in a retail setting – impacts the health of a patient and can dramatically change the outcome of a claim. Today’s PBMs must manage an injured worker’s pharmacy care to support health and safety, no matter where the medication is dispensed or who bills it. New dispensing and billing practices bring inflated prices for traditional medications, and because of our broad Coventry network capabilities, we are able to aggressively reduce each prescription to its lowest defensible rate for our customers.

“Coventry manages over two million prescriptions annually between the First Script PBM program and non-PBM sources,” said Brian Carpenter, vice president of pharmacy product development for Coventry. “Our results are significant and highlight the importance of utilization management including all prescriptions.”

One of the most critical patient safety issues in 2012 was narcotic overutilization. Through the application of clinically-based programs and enhanced client education, First Script clients realized meaningful decreases in narcotic utilization in 2012. For claims between years one and ten, narcotic spend and scripts per claim decreased 17% and 15%, respectively, versus 2011.

When discussing narcotic safety, decreases in Morphine Equivalent Dose (MED) may prove to be even more meaningful than changes in script volume or spend. MED is the conversion of various opioids to a Morphine Equivalent Dose by the use of accepted conversion tables that outline relative potency, duration of action, side effects, etc. Since 2010, the average MED for First Script injured workers has declined 11% in the first two years post-injury, and 8% in years two to five.

To learn more about this year’s analysis and Coventry’s pharmacy cost management strategies, a webinar will be offered on July 10, 2013.

Register for the webinar here: First Script 2012 Pharmacy Trends Webinar

Download a copy of the report here: First Script 2012 Pharmacy Trend Analysis (PDF)

Source: Coventry WCS

Coventry WCS is a WorkCompWire Advertising Partner.
This is not a paid placement.

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