By Phil Walls, RPh, Chief Clinical Officer, myMatrixx
myMatrixx released our 2018 Drug Trend Report on April 18, and it contained a lot of good news along with some cautionary warnings. First, the good news.
Both the price per pill and utilization declined overall; opioid use took a big dip with average spending for opioids dropping 15% across all our payer-clients. For some clients, opioids were bumped out of the number-one most used therapeutic class.
Of course, when opioid scripts decline, payers worry that prescriptions for other dangerous, potentially addictive drugs like benzodiazepines and sedative hypnotics, will increase. That did not happen.
In fact, scripts for both categories fell, with benzodiazepines dropping from 1.4% of the prescriptions we processed in 2017 to 1.3% in 2018, and sedative hypnotics going down from 1.7% to 1.4% —due in part to the aggressive pharmacovigilance component of myMatrixx’ Get Ahead of The Claim program. This program has been the mainstay of our clinical strategy for over a decade now and still provides our clients with an agile pharmacovigilance program that monitors the use of all dangerous and excessively priced drugs and mitigates their risk.
The only traditional drug categories that experienced increases — and these were slight — were NSAIDs and gabapentin. There was a 1% increase in NSAID scripts, and gabapentin increased from 5.8% to 6.0% of the scripts we processed.
While NSAIDs in particular are generally preferred for pain management, their use requires careful monitoring as they have their own set of issues, including cardiovascular complications among others. Monitoring is especially important for aging workers. The Beers Criteria lists medications that should be used with caution —if at all — for seniors, and that list is eerily similar to the list of commonly prescribed workers’ compensation drugs.
I will dive deeper into side effects and other complications from these medications in upcoming FaceTime with Phil blogs. Register here for notifications.
On a watch-with-caution topic, injured workers’ use of specialty drugs, especially HIV medications, increased by 18.5%. While usage of these drugs is quite low at 1.7%, they represent 7.6% of clients’ drug spend. Of course, many workers’ compensation payers will never see these scripts as they are mainly used in certain occupations, including first responders, public safety personnel, law enforcement and correctional officers, healthcare workers, and for certain defined occupations in states with cancer presumption laws.
These are rare and extreme cases, but they come with extreme costs. Please refer to our research paper Specialty Drugs in Workers’ Compensation: A Population Based Assessment (PDF), for more details on these. In addition, please watch the Thought Leadership portion of our website for an important revision coming to this paper this summer.
Looking forward, there are exciting new HIV therapies coming on to the market, along with the potential for abuse-free opioids. In addition, the use of pharmacogenomics — using DNA to select medications — is coming closer to widespread use and the test prices are dropping.
Future FaceTime with Phil blogs will address these in more detail; in the meantime, Download our free Workers’ Compensation Drug Trend Report
This is a sponsored post from WorkCompWire marketing partner myMatrixx.