Noticeably absent from the Rx Drug Abuse Summit are non-work comp or Medicaid payers. The third-party payer track is dominated by workers’ comp PBMs, payers, and researchers. Sessions are well-attended, well-done, and worth while.
One wonders if private insurers selling group health or individual coverage don’t have problems with abuse of prescription drugs, or perhaps more precisely, don’t think it’s a problem for their business.
Well, it is.
- Researchers believe each doctor shopper costs upwards of $10,000.
- Total costs to private insurers – back in 2007 – were north of $20 billion.
- Costs for all insurers, public and private, are upwards of $70 billion annually.
- Eight years ago, almost half of Aetna’s member fraud cases involved prescription drugs, with most of those doctor-shopping.
Kudos to work comp for taking the lead on this critical issue. Here’s hoping the rest of the world follows your lead; the chances for success are going to be much greater, and that success will come much faster, if private and public health insurers get involved.