Maggie Valley, NC – CompPharma, LLC a consortium of workers’ compensation pharmacy benefit managers, has published its second free research paper on compounding in workers’ compensation entitled “Compounds in Comp: A New Look at Patient Safety, Efficacy and Cost”.
Written by pharmacists and public affairs professionals working for CompPharma’s member PBMs, the paper examines patient safety, efficacy, quality, and cost issues surrounding compounds in workers’ compensation.
“Even topical compounds can be dangerous,” said Lead Author Phil Walls, RPh, Chief Clinical Officer for myMatrixx. “Exposure to high concentrations of local anesthetics found in some compounded creams can cause seizures and irregular heartbeats, and there have been deaths associated with their use.”
Authors stress their support of traditional compounding, which FDA defines as “the extemporaneous combining, mixing or altering of ingredients by a pharmacist in response to a physician’s prescription to create a medication tailored to the specialized needs of an individual patient.” Much compounding in workers’ compensation involves creating a compounded product, marketing it to prescribers and billing exorbitant prices. The paper shows how the Average Wholesale Price benchmark has been manipulated to drastically inflate compound prices and outlines state legislative and regulatory controls.
One section examines healthcare fraud linked to compounding, including a recent workers’ compensation case involving kickbacks to providers who prescribed compounded creams and pharmacies that mass-produced compound transdermal creams for approximately 13,000 injured employees.
“Payers should ask their PBMs to develop strategies to identify all compounds, and policy makers should require pre-authorization on compounds and individual ingredient billing data,” said CompPharma President Joseph Paduda. “And they should not reimburse components that lack a National Drug Code (NDC).”
“Compounds in Comp: A New Look at Patient Safety, Efficacy and Cost” was written by Phil Walls, RPh, myMatrixx; Deborah Conlon, RPh, PharmD and Kevin Tribout, Optum Rx; Brigette Nelson, MS, PharmD, Express Scripts; and Nikki Wilson, PharmD, MBA, Coventry.
Download the free report here: CompPharma: Compounds in Comp: A New Look at Patient Safety, Efficacy and Cost (PDF)