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Work comp pharmacy…

has changed dramatically in the last 18 years.

Costs are much lower, brand drug usage has fallen off a cliff, PBMs are by far the dominant delivery channel, and there aren’t any real problems these days/

At least that’s what I’ve gleaned from doing 15 surveys of work comp execs on their perspectives and quantitative measures related to pharmacy.

Way back when:

Expect we’ll have the latest version of our annual survey in late January; in the meantime (and VERY preliminary:

  • generic fill rates are around 90%
  • generic efficiency is north of 98%
  • inflation trends appear to be negative – for about the 7th straight year.

Yet payers are still concerned about drugs, mostly because they are seen as major contributors to disability duration and recovery.

What does this mean for you?

Its not just the cost – it’s the knock-on effects. 

4 thoughts on “Work comp pharmacy…”

  1. Joe, thank you for your time and energy throughout the year to both share your insights and build bridges among the comp community. Wishing you and your readers a blessed Thanksgiving, Marc

  2. Good morning! What are your thoughts on physicians who dispense medications from their offices directly to patients? These costs tend to be significantly higher than average retail pharmacy in my experience in Virginia.

    1. Hello Teri and welcome to MCM.

      Physician dispensing is a significant patient safety issue, extends disability duration, increases overall medical costs, drives up pharmacy expenses and should be banned. period.

      I’ve written about this extensively – just type “physician dispensing” in th search box on the right of the blog home page.

      be well – Joe

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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