My firm, Health Strategy Associates, is conducting the Third Annual Survey of Prescription Drug Management in Workers Comp, and I’m hoping to have the final report completed before the end of April. Here are a couple of interesting bits that have come up in the 20+ interviews conducted to date.
1. There is a rather striking difference in the pharmacy inflation rate between what I would characterize as less- and more-sophisticated payers. Some payers have held their inflation rates down in the lower single digits, others are seeing trend rates above 15%.
2. Claim frequency decreases get part of the credit for low pharmacy inflation, but not all of it.
3. The number of PBMs is growing, but no PBM has a dominant market position. In fact, many senior execs don’t know much about the PBMs beyond their names.
4. Cost inflation tends to be attributed to more “designer” drugs, e.g. more expensive branded drugs being prescribed when a cheaper generic would likely work; direct to consumer advertising’s impact on consumers, and more claimants getting more drugs for longer periods.
5. This last is probably the most consistent thread running throughout the interviews – a heightened awareness of and concern about the sheer volume of drugs prescribed.
I’ll post additional highlights when they make themselves apparent. If you want a copy of the survey report, email me at jpaduda@healthstrategyassoc.com.
Insight, analysis & opinion from Joe Paduda