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California’s workers compensation drug formulary continues to reduce pharmaceutical costs and shift prescribing to drugs not subject to utilization review, according to meeting minutes released Tuesday from the Workers Compensation Insurance Ratings Bureau’s actuarial committee review of the formulary in December.
The evaluation of the formulary’s impact on drug utilization in the state — focused on pre-pandemic figures — revealed that workers compensation pharmaceutical costs have continued to decline since the implementation of the formulary on Jan. 1, 2018, but at a slower rate through 2019 and the pre-COVID-19 period in 2020.
The share of drugs prescribed that are not subject to utilization review also continued to increase, and the share of payments for opioids, compounds and brand name drugs with generic alternatives also continued to drop in the state.
However, the review noted that the share of payments for physician-dispensed drugs did increase slightly at the end of 2019.
Overall, the committee noted that the continued decrease in drug costs suggests that the formulary “is achieving its intended effects.”
More insurance and workers compensation news on the coronavirus crisis here.
Beginning Thursday, doctors in New York who need to prescribe drugs to injured workers will be required to adhere to the state’s drug formulary, a new system that classifies drugs as appropriate or requiring preauthorization, and includes an online portal to preauthorize certain medications such as opioids.