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Pharmacy costs in workers compensation have decreased by $1.1 billion during the past eight years as the result of fewer opioid prescriptions, among other reasons, according to a study released Wednesday by Maggie Valley, North Carolina-based CompPharma L.L.C.
Researchers analyzed the 2017 pharmacy cost data of 29 workers compensation insurers, third-party administrators, self-insured employers and state funds and reported a 8.8% decline in total pharmacy costs from 2016, according to the study. When compared to payers nationwide, the decline outpaces the 2.1% decrease in pharmacy spend nationwide, according to the 15th annual study.
“Pharmacy is no longer the fastest growing segment of work comp medical expenses,” Joe Paduda, president of CompPharma, said in a press statement. “Work comp payers, regulators and PBMs have been extremely successful in reducing drug spend, much more successful than other payers.”
All but four of the 29 firms surveyed spent less on drugs in 2017 than during the previous year, with seven respondents reporting declines greater than 15%, according to the study.
Twelve of the 29 participating comp firms credited clinical programs for the decrease while eight cited fewer opioid prescriptions, the study found. “The latter makes sense as workers compensation patients who take opioids usually also take other medications, often to combat opioid side effects,” Paduda said in the statement.
Researchers also asked respondents to identify the single biggest problem in workers compensation pharmacy and found the leading concerns to be prescriber behavior, pricing and pricing transparency, opioids, systemic complexity and impact on managing pharmacy, and regulatory compliance and related issues.
CVS Caremark is rolling out an opioid-utilization management program for all its commercial pharmacies, which means starting Feb. 1, 2018, the pharmacy will limit to seven days the supply of opioids dispensed for most patients who are new to the drug, according to an announcement made Thursday.