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Prescription cost per workers comp claim rose 7.3% in 2014


While the average cost per workers compensation claim increased in 2014, the number of prescriptions per injured worker and the average morphine equivalent dose per script declined, Coventry Workers' Comp Services said Tuesday.

Due primarily to a 10% increase in the average wholesale price of medications commonly prescribed to injured workers, the overall average cost per claim rose 7.3% in 2014 compared with 2013, according to Downers Grove, Illinois-based workers comp care and cost manager' 2014 First Script Drug Trends Analysis.

Increased prices to cover patents that will expire in the future and potential product shortages were among the biggest factors in the overall average wholesale price increase last year.

Meanwhile, the number of prescriptions per injured worker decreased 5%, narcotic utilization decreased 7.4% and the average morphine equivalent dose per script decreased 4.5%, according to the analysis.

Generic utilization increased 5.9% to 82% last year, according to the analysis.

Due in part to newly released generic formulations of two top 10 medications — Cymbalta and Lidoderm — “we saw the most significant increase in generic utilization in the last four years,” the analysis states.

According to Coventry, compound drugs accounted for 7.7% of all managed drug spending and 28.1% of all unmanaged drug spending in 2014, up from 4.5% and 20.1%, respectively, in 2013.

“The rising use of compound medications in workers compensation has created greater risks to injured worker safety and has become a cost burden on the system,” the analysis states.

The 2014 First Script Drug Trends Analysis is based on transactions billed through Coventry's pharmacy management program, First Script, as well as transactions from associated medical bill review systems.