By Dr. Mitch Freeman, Pharm.D., Chief Clinical Officer, Mitchell Pharmacy Solutions
In a year of big headlines, it is easy to lose track of the next three trends that are directly impacting your pharmacy program today (see our previous trend alert on COVID and opioids). Below are three trends you should have on your dashboard so you are not blindsided in 2021.
In our previous Leaders Speak article, we discussed the major pharmacy trend affected by the COVID-19 pandemic: the opioid epidemic. What other trends should the industry be tracking through the end of this year and into the next? Here are the top three Mitchell has identified to keep on your radar through 2021.
1. Marijuana Continues its Legalization Course
As public acceptance grows – with 70% of Americans finding smoking marijuana morally acceptable and Martha Stewart going mainstream with CBD – marijuana continues to be a hot topic in the workers’ compensation industry. Even with the pandemic at the forefront of policy, marijuana has still made headway toward legalization or expanded legalization in several states. This year has also ushered in new studies, with some looking at the health concerns related to THC and others examining the potential to treat pain.
Some recent updates include:
- Health Concerns: The American Heart Association released a memo warning of the potential danger to heart health for those who use THC products. A study released in JAMA found users of high-potency weed were more like to develop generalized anxiety disorder.
- Pain Relief: An analysis of state registry data for 20 states found that 65% of people who received medical marijuana cited pain as their qualifying condition. A look at 72 systematic reviews found that pain was the most common condition for people to use medical marijuana.
There still needs to be more research into how marijuana is potentially beneficial and what major side effects exist so states, physicians, payers and individuals can make the best decisions regarding the drug. It’s also important to know the current state laws and the most recent court precedents regarding coverage in your jurisdictions.
2. Topical Medications Continue to be a Concern
A study published in the National Library of Medicine found that, over the eleven-year span of 2005 to 2016, the AWP of generic topicals increased an average of 273% and the AWP for brand name topicals increased an average of 379%.
As these medications continue to increase in cost and utilization, the industry should pay careful attention to how their pharmacy programs are being affected. Many topicals are available as over-the-counter medications at a fraction of the cost of the brand name drug. Close monitoring of your pharmacy program, examination of ingredients within the topicals and enforcement of generics where possible will help reduce the impact of the spiraling cost of brand name topicals.
3. Therapeutic Alternatives Provide Option for Expensive Brand Medications
Many brand name drugs come in formulas that provide little additional benefit over generic medications, but cost exorbitantly more. One example is extended-release formulations, which one study found to have cost the healthcare system nearly $14 billion more than equivalent twice-a-day medications would have cost over the five-year span of 2012 to 2017.
Therapeutic alternatives provide options where no generic exists for the brand name drug. An example of this is Duexis, which is made of ibuprofen and famotidine. Duexis costs nearly $3,000 per month, while the two generic medications together cost little over $30.
In the workers’ compensation industry, it’s important to be aware of the different types of brand name drugs that could have therapeutic alternatives. Keep an eye out for similar ingredients with unique strengths, ingredients in long-acting forms (ER, XL, CR), and combinations of ingredients that are available separately as generics.
The Future of Pharmacy Care
As the world continues to battle the COVID-19 pandemic, we expect to continue to face these pharmacy challenges into 2021.
About Dr. Mitch Freeman
Dr. Mitch Freeman is the Chief Clinical Officer for Mitchell International, Pharmacy Solutions. Prior to joining Mitchell, Freeman was the CEO of First Coast Health. He has a wealth of industry expertise and leadership in the workers’ compensation industry including the chief sales and marketing officer of PMSI, vice president of sales at Ameritox, vice president and general manager for ExpressScripts, and president of pharmacy services for MSC.
Freeman is a frequent guest speaker and author. Freeman is a graduate of Florida A&M University where he received his doctorate of pharmacy.
Headquartered in San Diego, California, Mitchell International, Inc. delivers smart technology solutions that simplify and accelerate claims handling, repair processes and pharmacy transactions, driving more accurate, consistent and cost-effective resolutions. Mitchell integrates deep industry expertise into its workflow solutions, providing unparalleled access to data, advanced analytics and decision support tools. Mitchell’s comprehensive solution portfolio and robust SaaS infrastructure connect its customers in ways that enable tens of millions of electronic transactions to be processed each month for more than 300 insurance providers, over 70,000 pharmacies and 30,000 collision repair facilities, as well as countless other Property & Casualty industry supply partners across the Americas and Europe.
Mitchell, Genex, and Coventry have recently combined their joint industry expertise and advanced technology solutions into one organization to simplify and optimize property, casualty and disability claims processes and services. For more information, please visit Mitchell.com.
Mitchell is a WorkCompWire ad partner.
This is not a paid placement.