March 18, 2018

Healthcare Solutions’ Drug Trends Report Highlights Major Differences in Claim Age

Atlanta, GA – Healthcare Solutions, the parent company of Cypress Care, Procura Management, ScripNet, and Modern Medical, recently announced the release of its third annual Workers’ Compensation Drug Trends Report. The 2013 report is based on a thorough analysis of changes in prescription drug costs and utilization year-over-year.

Healthcare Solutions’ report is unique in segmenting pharmacy data based on claim age to report on significant differences in drug utilization discovered between developing claims (less than 3 years of age) and mature claims (3+ years). Consistent with previous studies, the report finds that mature claims utilize more drugs, more frequently, and for a longer period of time necessitating a different approach to claims management in this population. For example, mature claims receive more than five unique drugs per year on average as compared to three in developing claims. And, mature claims utilize an average of 22 prescriptions per year, compared to five fills per year in developing claims.

“Because of the differences among drug cost, mix, and utilization in developing versus mature claims, Healthcare Solutions’ clinical programs utilize different approaches to address the needs of each claim group,” said Jim Andrews, R.Ph, executive vice president of pharmacy services for Healthcare Solutions. “As a result of this unique approach, in mature claims we saw a reduction in the number of days injured workers used all classes of drugs, including opioids, and a decrease in drug spend from 2011 to 2012. These decreases are attributable to our targeted clinical outreach programs which are aimed at changing claimant drug therapies.”

Of significant importance, Healthcare Solutions’ programs have contributed to an overall decrease in opioid utilization for both developing and mature claims. Through Healthcare Solutions’ clinical and peer review programs, the report shows a reduction in the use of the most prescribed opioid, hydrocodone-acetaminophen, and highly abused long-acting opioids, leading to a decrease in the average morphine equivalent dose per day per claimant. Healthcare Solutions’ clinical outreach initiatives also decreased the risk of acetaminophen toxicity and associated liver damage by reducing the number of claimants receiving dangerous doses of acetaminophen by over 50%.

To obtain a copy of the 2013 Drug Trends Report visit

Source: Healthcare Solutions

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