I’m up to my eyeballs in the 13th (!!) Annual Survey of Prescription Drug Management in Workers’ Compensation; the response from payers willing to devote time to the project has been gratifying indeed.
Previous Survey reports are available here; note these are the Public versions; respondents get a much more detailed and comprehensive version.
A bit of background first. I conduct these surveys telephonically, speaking to the individual at the insurer/self-insured employer/state fund/TPA/trust who is directly responsible for the pharmacy program. In addition to asking their opinions and views, we get data on a variety of key metrics including:
- drug spend for 2015 and 2014
- opioid spend for 2015
- compound drug volume
- generic fill and efficiency rates
- mail order usage
A few early findings.
- Pharmacy continues to be seen as more important than other medical ost areas, primarily due to the “downstream” effects of opioids on claim duration, return to work, and related pharmacy spend.
- Most respondents are seeing a decline in drug spend. This is a bit of a surprise, as national research suggests drug costs are going up. A possible explanation is that (most of) these payers are pretty sophisticated, have been working diligently on pharmacy issues for years, and most (but certainly not all) have employed a variety of programs to reduce unnecessary use of potentially dangerous drugs.
- The percentage of spend that goes to opioids varies greatly, from around 21% to over 50%. Some of this is due to regional or state differences, but much is not. Much more to dig into here.
- Mail order continues to be woefully under-used, with most respondents reporting penetration rates in the low single digits. Argh.
- Compound drugs are seen as highly problematic and payers have a wide variety of programs/efforts/mechanisms in place to address compounds.
Much more to come; when the Survey Report is done I’ll post a link.
Enjoy the weekend!