Opioid painkiller abuse and physicians' dispensing of repackaged drugs top the list of cost drivers in the 2012 Survey of Prescription Drug Management by CompPharma, LLC, a consortium of workers' compensation pharmacy benefit managers.
Respondents say opioids are the biggest problem in workers' compensation pharmacy management and most report implementing programs to address opioid overuse and abuse. These programs include 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.
Physician dispensing of marked-up repacked drugs came in as the second highest cost driver. Specific concerns include:
* 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 costing much more than the same medications dispensed at retail pharmacies.
* Extended disability duration.
* Higher overall medical costs.
Respondents include decision-makers and operations staff of 18 workers' comp insurance carriers or third-party administrators. These companies' total prescription expenses amount 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.' This was three-tenths of a point higher than last year's results (3.8). Moreover, respondents are concerned (4.2) that drug costs will be more of a problem in the next 12-24 months."
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