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ARC: HOW EMPLOYERS CAN BETTER MANAGE THE PHARMACEUTICAL PORTION OF THEIR WORKERS COMPENSATION PROGRA

Cost of drugs for workers compensation claimants up in 2012

Prescription Drug Costs

The cost of drugs commonly prescribed for workers compensation claimants, including narcotic pain relievers, rose during 2012, reports released Monday by pharmacy benefit managers show.

Narcotic analgesics, commonly called opioids, accounted for the highest overall per-user-per-year cost among pharmaceuticals prescribed for injured workers, St. Louis-based Express Scripts Inc. reported in its 2012 Workers' Compensation Drug Trends Report.

Narcotic costs averaged $127.53 per 2012 prescription, a 15-cent increase from the prior year, according to the report based on more than 300,000 workers comp claims paid by its clients nationwide. The per-user-per-year cost of overall narcotic medications averaged $491.22 in 2012, which represented a $12.91 decrease from 2011.

But the cost decrease partly resulted from a drop in utilization, Express Scripts said.

“At $132.52, OxyContin (oxycodone extended release) had the highest average per-user-per-year cost and accounted for 9.7% of total drug spend in 2012, despite a 6.1% decrease in utilization,” according to the Express Scripts report.

While narcotics accounted for 36% of overall pharmacy costs among its clients, the pharmacy benefit manager helped them reduce average utilization per user by 2.7%, the report said.

“Since narcotics represent such a large portion of the drug costs for workers comp in general, (any decrease in) utilization can have a big cost impact,” said Jennifer Kaburick, director of workers comp product management for Express Scripts.

Westerville, Ohio-based Progressive Medical Inc. also reported that when comparing 2011 with 2012, its programs also reduced opioid prescription use per claim. When considering several factors, such as inflation and changes in product mixes, its workers comp customers claims saw a 4.2% decrease in opioid prescription cost per claim, Progressive Medical said.

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In addition to its programs for reducing opioid consumption, there is a general downward trend in prescribing opioid painkillers, Progressive said. That is due to changing prescribing patterns in response to federal and state guidelines, increased use of prescription drug-monitoring programs, and more urine drug testing for compliance, the company said.

For all workers comp pharmaceuticals, Express Scripts said its customers saw a 2.9% increase prescription costs driven by a 3.2% increase in costs per prescription offset by a 0.3% decrease in utilization.

Progressive Medical, meanwhile, said in its “Drug Trend Report,” that the Federal Bureau of Economic Analysis found that prescription inflation for general health care increased 3.6% during 2012.

But for its analysis, Progressive Medical analyzed about 200,000 claims and nearly 3 million workers comp prescriptions and those pharmaceuticals accounted for a higher-than-average inflation rate, it said.

While prescription drug inflation was less last year, 5.5% for 2012 versus 6.8% in 2011, the increase was still significant, Progressive Medical's report said. “Our programs effectively minimized the impact of (average wholesale price) inflation and resulted in an overall prescription spend decrease of 0.5%,” according to its report.

Progressive Medical also said its new report shows that “dermatological agents” have become one of the top five drug types consumed by injured workers. In contrast, last year the pharmacy benefits manager reported that opioids, anticonvulsants, anti-inflammatories, antidepressants and muscle relaxers comprised the top five drug categories.

Express Scripts also reported an increase in spending for dermatologicals, or medications applied to the skin for local relief of muscle strains, sprains and inflammation. It saw spending for those drugs rise 10.1% among injured workers.

Express Script's report also shows that the per-user-per-year spending for antidepressants rose 11.1% last year, reflecting an average prescription cost increase of 9.1%, coupled with a 2.3% increase in utilization.

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