Opioid painkiller abuse and physicians' dispensing of repackaged drugs tops the list of cost drivers in the 2012 Survey of Prescription Drug Management released by CompPharma, LLC, a consortium of workers' compensation pharmacy benefit managers. Joseph Paduda, principal of Health Strategy Associates and president of CompPharma, has conducted the study for nine consecutive years.
Respondents said opioids were the biggest problem in workers' compensation pharmacy management and most had implemented programs to address opioid overuse and abuse. These programs included nurses conducting specialty reviews, pharmacists contacting treating physicians, physician peer-to-peer contact, urine drug testing, education on proper dosage and monitoring and increased use of WC-PBM drug utilization, fraud and abuse programs.
Marked-up repackaged drugs
Physician dispensing of marked-up repackaged drugs came in as the second highest cost driver. Specific concerns were:
* Patient safety (physician-dispensed drugs do not go through a WC-PBM's drug utilization review process.)
* Potential duplicate therapy.
* Unnecessary medications and/or medications not related to the claimant's injury.
* Higher costs due to repackaged drugs priced above the same medications dispensed at retail pharmacies.
* Extended disability duration.
* Higher overall medical costs.
Respondents were decision-makers and operations staff at 18 workers' compensation insurance carriers or third-party administrators. These companies' total prescription expenses amounted to $473 million, 12% of total estimated workers' compensation drug spending.
"Despite relatively flat drug costs, respondents continue to be significantly concerned about the issue," the report states. "In response to the question 'How big a problem are drug costs?' on a 1-through-5 scale with 3 being 'drug costs are equally as important as other medical cost issues,' drug costs were rated a 4.1, or 'more important than other medical cost issues.'"
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