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Lack of transparency remains issue in comp pharmacy

Posted On: Nov. 12, 2019 11:40 AM CST

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A lack of transparency in workers compensation pharmacy continues to be an issue for much of the industry, according to a CompPharma study released Tuesday.

Opioid prescriptions and overall pharmacy spend declined between 2017 and 2018, reported Maggie Valley, North Carolina-based CompPharma in its 16th annual Survey of Prescription Drug Management in Workers Compensation study. However, 83% of the survey respondents said a lack of transparency in pricing remains their top issue in workers comp pharmacy, said the company in a statement.

For the survey, CompPharma reached out to decisionmakers, clinical personnel and operations staff from workers compensation insurers, third-party administrators, self-insured employers and state funds with average annual drug spend ranging from $400,000 to more than $200 million.

Overall drug spend based on data from the respondents decreased by about 10% between 2017 and 2018, according to the statement, which respondents attributed to renegotiated contracts. Opioid spend dropped by nearly 20%, with more than half of those surveyed reporting that they had made progress curbing the initial use of opioids and reducing long-term use.

Some respondents suggested that drug costs be separated from value-added services, such as clinical management, and stressed the need for vigilance in the event that some new cost driver is “right around the corner,” said the company.