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    Prescription Drugs and the Workers’ Compensation Cost Containment Arena

Prescription Drugs and the Workers’ Compensation Cost Containment Arena

The U.S. remains the biggest global consumer of prescription drugs, up from around 76 million in 1991 to nearly 207 million in 2013 however a recent court ruling has called into direct question the prescription practices of physicians nationwide (Volkow).

The occurrence of unnecessary or medically inappropriate prescribing of opioids in pain management is compromising the lives and well-being of injured workers.  There are a number of serious issues concerning the use of opioids in pain management:

  • Not cost effective
    Evidence-based reviews are seldom consulted prior to the prescribing of opioids, and […]

November 7th, 2016|Pharmacotherapy Review, Workers Compensation Payers|Comments Off on Prescription Drugs and the Workers’ Compensation Cost Containment Arena

What’s Trending with California Workers’ Compensation

Though workers’ comp claims frequency is declining, a recently released California hospital report indicates claim severity is on the rise. Obtaining data from 35 hospitals and individual facilities, the Milliman and Keenan Healthcare report sourced more than 3,500 claims for review.

Trends identified in the report:

  • A decline in indemnity and medical-only claims, with ALAE costs playing an increasing role in overall claims costs in recent years. More specifically:
    • Higher average costs per indemnity for workers over 30.
    • Lesser average severity of indemnity claims in workers 30 and younger, with payments more likely […]
October 28th, 2016|Pharmacotherapy Review, Workers Compensation Payers|Comments Off on What’s Trending with California Workers’ Compensation

Why ANS Pharmacotherapy Review is so Effective

The prescription pain medication crisis is taking its toll across the U.S. Costs are extreme, with a broad array of collateral damage fanning out from those effected to families and industries, among the hardest hit, workman’s comp. So extreme are the effects of addictive and deadly prescription opioids, even the Federal Government has taken notice, with the CDC stepping in to release new opioid prescribing best practices earlier this year in hopes of ushering in a new era for an ailing nation. The issue is out in the open. […]

October 17th, 2016|Drug Utilization Review, Pharmacotherapy Review|Comments Off on Why ANS Pharmacotherapy Review is so Effective

Bipartisan Opioid Abuse Bill

In an effort to reverse the rapidly rising death toll from heroin, prescription drugs, and opioids across the U.S. which has recently risen to surpass automobile accidents as the leading cause of injury-related deaths according to the CDC, legislation has been drafted in a rare bipartisan effort.

The Comprehensive Addiction and Recovery Act (CARA)
Designed to strengthen prescription drug monitoring programs, better trace the diversion of opioid drugs, and increase promotion and access to addiction recovery services, CARA will also open up a variety of prevention and treatment avenues:

  • Prevention and […]
September 26th, 2016|Drug Utilization Review, Pharmacotherapy Review|Comments Off on Bipartisan Opioid Abuse Bill

Patient Engagement and Prescription Drug Label Enhancements

Upcoming improvements to prescription drug labeling are hoped to positively affect patient care across the board. Intentionally kept in the dark on the ingredients and indications of prescription drugs for well-over 100 years, the healthcare industry is shifting from the past’s blind trust to finally realizing today’s modern paradigm: Engaging patients as active participants in their own healthcare endeavors.

Small Label, Big Impact
Improving the synchronization between in-office care and home care, the FDA’s latest labeling procedures will not only help patients under a physician’s care better understand why each medication […]

September 12th, 2016|Drug Utilization Review, Pharmacotherapy Review|Comments Off on Patient Engagement and Prescription Drug Label Enhancements

Is Regulation the Answer to Rising Pharma Costs?

National pressure has been building for government regulation on pharmaceutical costs.  A recent poll from the Kaiser Family Foundation found that 72% of Americans think drug costs are unreasonable and demand more transparency from drug companies, especially when it comes to how they set prices.(1) In the face of this discourse, the accountability of pharmaceutical companies has grown as a key focus of recent state and federal regulations.

In the state of Vermont, expensive prescriptions drugs distributed by manufacturers must now justify their exorbitant costs, according to a newly […]

August 30th, 2016|Medical Cost Containment, Pharmaceutical Cost Containment, Workers Compensation Payers|Comments Off on Is Regulation the Answer to Rising Pharma Costs?
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    The Importance of a Multifaceted Approach to Medical Cost Containment

The Importance of a Multifaceted Approach to Medical Cost Containment

The biggest hurdle in workers’ compensation medical cost containment is that the injured worker is not getting better. Even though WC claims have steadily declined over the last decade, medical costs keep rising as do the sub-par outcomes for the patient and the payer. What we are seeing is that the inter-connectivity of many factors is hindering the end goal of optimized outcomes. A multidimensional approach is crucial not only for combatting pharma costs, but also for ensuring optimal outcomes for injured workers.

At the end of the […]

August 15th, 2016|Medical Cost Containment, Pharmacotherapy Review, Workers Compensation Payers|Comments Off on The Importance of a Multifaceted Approach to Medical Cost Containment

Examining the Effects of Price-Focused Reform

Workers Compensation Research Institute (WCRI) recently conducted a series of studies aimed at examining the effects that federal and state regulations are having on the reduction of pharma spend. What the industry is seeing is an emerging trend in physician prescription reimbursement that begs the question, is price-focused reform effective?

One particular regulation, enacted to cap prices paid by tying the maximum reimbursement to average whole price (AWP) has left physicians in certain states dispensing new drug strengths and formulations […]

July 28th, 2016|Pharmaceutical Cost Containment, Pharmacotherapy Review|Comments Off on Examining the Effects of Price-Focused Reform

How Common is Illegal Drug Use Among Pain Patients?

At the American Pain Society’s 35th Annual Scientific Meeting in Austin, findings were released on the use of illicit substances among chronic pain patients. Of 450,081 patients included in a study by Baltimore-based pain medication monitoring firm Ameritox, 10.4% of urine samples tested positive for the use of at least one illicit substance.

How Many of Those Identified Were Workers Comp Patients?
Workers compensation was the primary payer for 22,525 of the 450,081 patients in the study, conducted between January 2013 and July 2015, which showed the use of illicit substances […]

July 7th, 2016|Drug Utilization Review, Medical Cost Containment, Opioid Abuse, Pharmaceutical Cost Containment, Pharmaceutical Industry, Pharmacotherapy Review|Comments Off on How Common is Illegal Drug Use Among Pain Patients?

Opioids Still the Top Prescribed Drug in California

Using data derived from the 10.8 million workers comp prescriptions dispensed between January 2005 and December 2014, a recently released report by the California Workers’ Compensation Institute identified opioids as the number one prescribed drug in California’s workers’ compensation system.

Report findings indicate that opioid prescriptions accounted for 27.2% of total prescribed pharmaceuticals. In addition, the average cost of opioid prescriptions rose by 85% from $61 to $113. In comparison, other prescription drugs within the same time frame experienced only a 39% increase, from $94 to $131. The report also […]

June 28th, 2016|Opioid Abuse, Pharmacotherapy Review|Comments Off on Opioids Still the Top Prescribed Drug in California