BI’s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.

To search specifically for more than one word, put the search term in quotation marks. For example, “workers compensation”. This will limit your search to that combination of words.

To search for a combination of terms, use quotations and the & symbol. For example, “hurricane” & “loss”.

Login Register Subscribe

PBM sees largest drop in prescription costs in decade: Report

prescription drug costs

Analyzing 850,000 claims, one large pharmacy benefits manager is reporting an 8.3% drop in prescription drugs costs in workers compensation in 2018, according to a report released Monday. 

The drop — the largest in a decade — is attributed to three factors: a 4.1% increase in wholesale pricing making up the lowest drug inflation experienced in 10 years; a 7.3% decrease in drug utilization in comp; and a 5.1% decrease in “product and claim mix,” namely new clinical and intervention programs to improve drug overutilization and treatment, according to the report released by Optum Workers’ Comp and Auto No-fault Solutions.

The opioid spend also saw a record decrease of 18.8% in 2018, according to the Eden Prairie, Minnesota-based PBM. Overall, 43.3% of claims in 2018 included opioid prescriptions, down from 49.4% in 2017 and 53.7% in 2016, the report shows.

The PBM also noted increases of prescribing of opioid alternatives. Namely, the spend for anti-inflammatories increased from 14.7% in 2017 to 16.8% in 2018 and the spend for anticonvulsants increased from 10.7% to 11.1% over that same time, according to the report.

In 2018, generic utilization and generic efficiency percentage rates remain steady and high at 86.2% and 99.7%, respectively, according to the report. “Highlighting the importance of these numbers is the fact that, with every 1% increase in generic utilization there is a 3.5% decrease in spend,” the report states.






Read Next

  • States fight long battle to curb prescription costs

    The practice of patients getting their prescriptions filled at their doctors’ offices fell under scrutiny more than a decade ago, as workers compensation payers noticed how the medications were costing significantly more than what was doled out at a traditional pharmacy.