By Joe Paduda
Wednesday, September 7, 2022 | 0
There has been a lot of news around the working pharmacy lately. It’s time to dive into what’s going on, why, and its implications.
No better place to start than with the study just released by the Workers Compensation Research Institute on the latest drug trends in 28 states. (Register here for the free webinar at 2 p.m. EST on September 29).
The research looked at trends over the three years from Q1 2018 to Q1 2021 (kudos to WCRI for quickly releasing this very recent information).
Key findings from research by Dongchun Wang, Vennela Thumula and Te-Chun Liu include:
- Prescription payments (all numbers are per claim) fell 15% or more in nearly two-thirds of the 28 states, but rose in Connecticut (22%), Florida (17%) and Pennsylvania (14 %). Hmmm.
- Notably, a major driver of the increase in these states was dermatological agents, driven by distribution by physicians and/or mail-order drugstores in these three states (and others).
- COVID is a non-factor; COVID claims represent less than 2% of total Rx costs in most states.
- More good news: Opioids continued to decline in all 28 states, A LOT. As in a 56% drop in the median state.
- The largest drop in spending occurred in New York, a 43% drop due to the adoption of a form in early 2020.
- The range of expenses is truly striking. In Q1 2021, the lowest state expense for claims with all medical expenses was $22 (Massachusetts, Minnesota, Wisconsin); the highest was almost 10 times higher in – you guessed it – Florida, at $201.
States that do/allow/do not prevent abusive prescribing and dispensing – looking at you, Connecticut, Georgia, Florida, Louisiana, Pennsylvania, South Carolina and others – allow scammers and thieves to steal money from employers and taxpayers while overtreating patients.
Lotions, aka dermatological agents, are almost entirely a (choose your term) that are enabled and perpetrated by medical distributors and some mail-order pharmacies, and by the lack of aggressive and helpful action by employers, insurers and their lobbyists.
Insurers, employers and taxpayers in these states are going to get hammered by these bad actors. The costs of dermatological agents have increased by more than 50% in Pennsylvania, Connecticut, South Carolina, Florida, Georgia, Virginia, North Carolina and Michigan.
Given the lack of an effective response from payers, their lobbyists and government business entities, you can expect the same.
What does this mean for you?
Great job on the opioid front, even though just cutting back on opioids isn’t THE solution to pain; it requires a multi-pronged approach.
As for dermatological agents, do you like getting screwed by profiteers?
Joseph Paduda is co-owner of CompPharma, a consulting firm focused on improving pharmacy workers’ compensation programs. This column is republished with her permission from her Managed Care Matters blog.