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Drugs and workers’ comp, part 1

Download the latest Survey of Prescription Drug Management in Workers’ Comp here

Key takeaways

  1. Total drug spend in workers’ comp was likely around $2.9 billion in 2021.
  2. The multi-year decline in drug spend seems to have flattened out; across all 31 respondents spend ticked up 0.82%.
  3. Opioid spend continued to drop, with 2021 figures showing a 12.5% drop over the previous year. Opioids represented 13.4% of all respondents’ pharmacy, the lowest figure in the two-decade history of this survey.
  4. Legacy opioid patients continue to be a challenge for many payers; most have adopted a “we’ll do whatever might help” approach to these patients.
  5. Physician dispensing is once again rearing its ugly head with respondents rating it the single biggest problem in workers’ compensation pharmacy after a multi-year hiatus from that august position.
  6. Payers continue to highly value PBM customer service; myMatrixx continues to lead the industry in that key category.

Media – if you’d like a much more detailed version of the report (which respondents receive) please leave a request in the comment section.

4 thoughts on “Drugs and workers’ comp, part 1”

  1. Thanks for publishing this. Curious what leads to the change in atmosphere on physician dispensing. Are there a few bad bad actors that give the whole space a bad name? Where is the whole space bad actors?

    1. E Scott – most welcome.

      There are many “bad actors” – mostly in Florida, Maryland, and in the mail order pharmacy business. My best guess is about a half-billion dollars of spend are due to these bad actors.

      Tellingly, there was a strong correlation between payers with increasing Rx costs and their level of concern re physician dispensing.

      Hope that helps.


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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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