According to CompPharma’s 2012 Survey of Prescription Drug Management in Workers’ Compensation
TAMPA, FLA. (January 9, 2013) — Opioids and physician dispensing of repackaged drugs topped the list of cost drivers in the 2012 Survey of Prescription Drug Management released by CompPharma, LLC, a consortium of workers’ compensation pharmacy benefit managers (WC-PBMs). Joseph Paduda, principal of Health Strategy Associates and president of CompPharma, has been conducting the study for nine consecutive years.
Respondents said opioids were the biggest problem in work comp pharmacy management and most had implemented programs to address opioid overuse and abuse. These programs included nurses conducting specialty reviews, pharmacists contacting treating physicians, physician peer-to-peer contact, urine drug testing, education on proper dosage and monitoring, and increased use of WC-PBM drug utilization, fraud and abuse programs.
Physician dispensing of marked-up repacked drugs came in as the second highest cost driver. Specific concerns were:
- Patient safety (physician-dispensed drugs do not go through a WC-PBM’s drug utilization review process, potential duplicate therapy, unnecessary medications and/or medications not related to the claimant’s injury
- Higher costs due to repackaged drugs costing much more than the same medications dispensed at retail pharmacies
- Extended disability duration
- Higher overall medical costs
Respondents were decision makers and operations staff of 18 workers’ compensation insurance carriers or third-party administrators. These companies’ total prescription expenses amounted to $473 million, 12 percent of the total estimated workers’ compensation drug spend. Conducted during the fall of 2012, the survey used payer prescription data from 2011 and a summary may be downloaded from here.
Established by industry consultants Joseph Paduda and Helen Knight, CompPharma, LLC is a consortium of workers’ compensation PBMs active in workers compensation. Member PBMs are Cypress Care, Express Scripts, Healthesystems, Modern Medical, Inc., MyMatrixx, PMSI, Progressive Medical Inc., ScripNet, and SXC Health Solutions. More information is available at www.comppharma.com or by contacting Helen Knight at 813-837-1701 or firstname.lastname@example.org.
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Media Contact: Helen Knight, 813-837-1701; email@example.com