Workers comp drug spending down 8.7% nationwide

More control over drugs such as powerful opioids, better integration with pharmacy benefits managers and prescriber interventions are among the reasons employers spent 8.7 % less in workers compensation drugs costs in 2015, according to a survey released Tuesday by a workers compensation PBM consortium.

CompPharma L.L.C.’s 13th annual Survey of Prescription Drug Management in Workers’ Compensation study revealed the latest round of data to be in line with a steady decrease in spending, with payers surveyed since 2011 having seen costs drop by 11%. The downward trend was interrupted in 2014 with a 6.4% increase over 2013’s results, an increase CompPharma pinned on inflation. 

The current decrease, meanwhile, was not related to a lower number of claims, the report states.

“Twenty percent of the respondents also had assertive settlement initiatives and have been closing older claims,” Joseph Paduda, president of CompPharma, said in a statement. “Overall, payers have seen drug costs go down by 11% in the past six years despite the 2014 increase.”

According to the survey, opioids remained the No. 1 payer concern. The report states that workers comp payers spent $1.54 billion on opioids in 2015, which was 13% of the total spent on opioids in the United States. The report compared this to the total work comp medical spend of less than 1.25% nationwide.

All payers surveyed have opioid management programs to limit the number of opioid prescriptions, according to the statement.

Meanwhile, reactions to PBM consolidations were mixed: Some respondents hoped mergers would bring better pricing and more clinical capabilities, while others expressed concern that the lack of competition would breed complacency.

“There is a sense of acceptance along with a little wariness about potential customer service issues,” Mr. Paduda said. “Consolidation in other segments of the industry has spawned customer service problems when people-based operating models were replaced with offshored or tech-enabled models.”

Researchers analyzed 2015 pharmacy cost data of 30 workers compensation insurance carriers, third-party administrators, self-insured employers and state funds.