CALIFORNIA Statistics on How Pharmaceuticals Affect Workers Comp Cost

Here is a synopsis of “Changes in Pharmaceutical Utilization and Reimbursement in the California Workers’ Compensation System,” available at http://www.cwci.org/

Rising RX & Payment Costs Statistically – Part 1

1. The average number of prescriptions and total pharmaceutical payments per claim in California workers’ compensation are up sharply since 2002, despite medical reforms and the adoption of a pharmacy fee schedule.
2. Average number of prescriptions (RX) and pharmaceutical payments per claim (PPC)rose from 3.5 in 2002 to 5.0 in 2007, a 52% increase in 6 years.
3. The cost of first-year prescription payments (PP) rose from $269.05 to $461.90 an increase of 72%, a rise only partially due to increased number of RXs per claim (workersxzcompxzkit)
4. The average payment for generics declined in the same 6-year period, while “brand” meds rose by 56%.
5. The study claims growth in total RX cost to both increased utilization and a shift to “brand” medications.
6. In years 2005-2007, the average number of first-year RXs per claim rose 25% and first-years PPC rose 35.6%

Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: [email protected] or 860-786-8286.