Steven Webb, President, Workers’ Compensation PBM, Express Scripts
… on the growing trend of compounded medications
Why are payers shouldering an increasing financial burden for treatment that is not medically necessary?
Our research, reported in the Express Scripts Workers’ Compensation Drug Trend Report, shows that the cost and utilization of compounded medications jumped 126% per-user-per-year in 2013.
So what’s driving this increase? Do more patients need compounded medications? No.
Our recent study with CompPharma, a consortium of workers’ compensation pharmacy benefit managers, found no clinical evidence that compounded medications commonly used in workers’ compensation are more effective than commercially available, manufactured drugs. And in fact, these drugs could pose serious patient safety concerns.
Express Scripts is proactively addressing this for compounded medication in workers’ compensation through our physician communications, as well as our prior authorization capabilities. In the coming weeks, we’ll launch communication directly to injured workers about the safety concerns and added cost for their workers’ compensation payers.
The rise of compounded medications is a growing problem that warrants your attention. We’re committed to helping payers navigate the challenges to ensure optimal treatment outcomes at lower cost.
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Study Investigates Effectiveness of Compounds
A recent study found no clinical evidence that compounds are more effective than commercially available, manufactured drugs.
At Express Scripts, we leverage the insights from our clinical research to develop innovative solutions that help workers’ compensation payers rein in costs, while ensuring the safety of injured workers.
We also collaborate widely with others across the workers’ compensation industry to proactively identify emerging issues facing payers. Acting as a trusted adviser, we develop strategies to address those issues.
We recently teamed up with other members of CompPharma, a consortium of workers’ compensation pharmacy benefit managers, to analyze the use of compounded medications in workers’ compensation. Our analysis found no clinical evidence that compounded medications commonly used in workers’ compensation are more effective than commercially available, manufactured drugs. Compounded medications are tailored drugs prepared by mixing, combining or altering ingredients.
Compounded medications generally do not have standardized dosages and duration for use, and do not undergo the same rigorous drug review process as commercially available drugs, which are approved by the FDA. Study findings suggest that because of this, compounds could pose patient safety concerns.
Express Scripts is already proactively addressing the issue of compounded medication in workers’ compensation through our physician education program, as well as our prior authorization capabilities. We are aligned with our clients in their need to ensure optimal treatment outcomes at lower cost.
Our upcoming 2013 Workers’ Compensation Drug Trend Reportwill discuss compounded medications and their impact on pharmacy spending in workers’ compensation in more detail. The report, to be published April 10, will also highlight other significant trends in the workers’ compensation pharmacy benefit.
Click here to read the full analysis.
On May 29, Sarah Randolph presented at a webinar hosted by IAIABC about this study. The slides are available for download here.
Visit Express-Scripts.com/WorkersCompensation for more information on industry-leading solutions to help control the cost of your workers’ compensation pharmacy spend.
Author Sarah Randolph, PharmD, RPh, Express Scripts. Sarah Randolph is a clinical pharmacist with the Express Scripts Workers’ Compensation division. She assists employers with their formulary design, drug utilization programs, and serves as an overall clinical resource.
