Maggie Valley, NC – CompPharma recently released its 15th Annual Survey of Prescription Drug Management in Workers’ Compensation, which found that pharmacy costs in workers’ compensation have decreased by $1.1 billion during the past eight years.
“Pharmacy is no longer fastest-growing segment of work comp medical expenses,” said Joe Paduda, president of CompPharma, LLC. “Work comp payers, regulators and PBMs have been extremely successful in reducing drug spend, much more successful than other payers. Survey respondents reported a 9.84 percent decline in total pharmacy costs during the past year, while the national spend across all payer types decreased by a paltry 2.1 percent.”
Twelve of the 29 respondents credited clinical programs for the decrease while eight cited fewer opioid prescriptions. “The latter makes sense as workers’ compensation patients who take opioids usually also take other medications, often to combat opioid side effects,” Paduda said.
Despite their success, payers remain focused on opioid management. “They know that far too many patients still use opioids and are concerned about the risk of addiction and dependency,” Paduda noted.
The trend toward consolidation in the PBM industry concerned some respondents. “Some payers believe the large PBMs will be less willing to compete for their business and less willing to customize programs for them,” Paduda said. “At the same time, some see the potential that more resources and better buying power will help them further reduce costs.”
The survey analyzed the 2017 pharmacy cost data of 29 workers’ compensation insurance carriers, third-party administrators, self-insured employers, and state funds.
Click here for a complimentary copy of CompPharma’s 15th Annual Survey of Prescription Drug Management in Workers’ Compensation.