NCCI Publishes 2010 Workers Comp Prescription Drug Study Update

NCCI Holdings Inc. recently unveiled an updated study that shows that the volume of prescription drugs dispensed to workers compensation claimants has risen sharply—putting upward pressure on costs.

 

 

The volume of prescription drugs dispensed by physicians to workers comp (WC) claimants has risen sharply in recent years—putting upward pressure on WC costs. This updated NCCI study investigates the increase and other issues associated with WC prescription drug (Rx) costs. (WCxKit)

 

 

 

1.      WC costs due to physician-dispensed drugs rose dramatically in 2008.

2.      Three-fourths of WC repackaged drug costs originate from physicians

3.      Lower than expected emergence of Rx costs has prompted us to lower our projected ultimate Rx share of total medical from 19% to 18%.

4.      After two seemingly abnormal years in which price change was the dominant factor affecting per-claim WC Rx cost increases, utilization change has once again taken its historically dominant role.

5.      OXYCONTIN® has become the top prescribed (in terms of paid dollars) WC Rx. A successful patent defense, which resulted in the removal of the extended release generic version of OXYCONTIN® from the market, is likely the major contributing factor.

 

 

In addition to a new look at physician-dispensed drugs NCCI has updated prior analyses for:

 

6.      The prescription drug share of total medical costs by injury year

7.      Changes in price, utilization, and cost

8.      Prescribing patterns

9.      Drug rankings by overall cost

 

 

Prescription drugs have been a significant driver of WC medical costs for many years.

 

 

NCCI first examined WC Rx issues in 2003 and found that utilization (as opposed to price) increases were the significant force behind Rx cost increases at that time. In 2007, NCCI found that state cost differences were driven mostly by the mix of drugs prescribed (as opposed to price or number of scripts). Several drugs, such as ACTIQ® and MOBIC® have shown significant changes in market share over the course of these prior studies. (WCxKit)

 

 

For further historical details, see the previous five studies—available for download at ncci.com

The moral of the story …. make sure you have a good PBM program. Ask your TPA to do a dog and pony show about their current service so you can learn more about it.