Payment per claim for prescription drugs used to treat injured workers in Illinois was slightly lower than in most study states, according to a new study by the Workers Compensation Research Institute (WCRI). It is interesting to note, in Illinois physicians both dispense and prescribe medications.
The 16-state study by the Cambridge, MA-based WCRI found the average payment per claim for prescription drugs in the Illinois workers’ compensation system was $361, slightly lower than the median of the study states. The average price per pill paid to pharmacies in Illinois was close to the 16-state median. Typical prices were seen for medications used most commonly in treating injured workers.
The WCRI study, Prescription Benchmarks for Illinois, found although the average price per pill paid to pharmacies in Illinois was close to the median of the 16 states, the price was higher in Illinois compared to what was paid in nearby states (Indiana, Iowa, Michigan, and Wisconsin).
The study also noted the utilization of prescription drugs in Illinois was similar to the median states, reflected in the average number of pills per claim and the average number of prescriptions per claim with prescription. Typical utilization was seen for the medications commonly used to treat injured workers in Illinois.
Prescription costs per claim in Illinois might be lower, except physicians tend to dispense higher priced medications, WCRI reported.
Some Illinois physicians wrote and dispensed prescriptions at their offices directly to the patient. Physicians dispensed 22% of all prescriptions. When physicians dispensed prescription drugs, they were paid a higher fee than what pharmacies are paid for the same medication by prescription. (workersxzcompxzkit)
For example, the average price per pill paid for Vicodin® was $0.78 when dispensed in office by the physician. When filled as a prescription to pharmacy, the medication cost $0.53.
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, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: [email protected] or 860-553-6604.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.
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