Insight, analysis & opinion from Joe Paduda
Last week I posted on the pending change in pharmacy pricing that will reduce prices by about 4% for most brand drugs. The pharmacy and big food-and-drug chains are negotiating with the big PBMs; they are seeking ‘cost neutrality’; that … Continue reading The coming change in drug pricing
Read More...My firm, Health Strategy Associates, has conducted a survey of prescription drug management each year for the last five. I’m well into the survey portion of the Sixth Annual Survey, and here are some preliminary findings. 1. Drug cost inflation … Continue reading The Sixth Annual Survey of Prescription Drug Management in Workers’ Comp – (very) preliminary results
Read More...There are two key takeaways from the WCIRB report on California’s work comp costs (as reported by workcompcentral.com). Medical costs are rising fast, and managed care costs are rising much faster. Medical expenses climbed 7.9% last year, led by a … Continue reading Comp cost escalation in California; no answer in sight
Read More...From the world of workers comp comes a crystal clear picture of what’s wrong with America’s health care system, and how difficult it will be to get it right. WorkCompCentral has a piece this morning about California’s proposal to not … Continue reading Why health reform will be so tough
Read More...Dave North, CEO of Sedgwick CMS was one of the morning panelists. He began with a rather strong statement about workers comp, a statement that was also an indictment of the industry’s complete inability to manage medical – the fact … Continue reading WCRI – Medical costs are up because solutions don’t work
Read More...If you’ve been wondering why your company is paying so much for high-powered pain medications, here’s why. Cephalon, manufacturer of Actiq and Fentora, has: “agreed to plead guilty to promoting off label use of its painkiller Actiq–which was widely used … Continue reading Cephalon – the worst of the worst
Read More...New York announced significant (some would say drastic) changes to the state’s WC Laws and Regulations last summer. These changes will result in a dramatic decrease in WC premium rates in the state, something long overdue, and much welcomed. There … Continue reading The latest on NY’s WC Rx changes
Read More...The regulators in NY have decided that drugs for work comp claims will be reimbursed at the Medicaid fee schedule plus a dispensing fee. That is a huge change from the prior reimbursement level of usual and customary, which in … Continue reading NY’s new WC Rx fee schedule
Read More...For the dozen folks who find this remotely interesting – A few factoids and interesting tidbits from around the WC PBM world. The legislative efforts in California to address repackagers and dispensing of drugs by physicians appears to be stalled, … Continue reading Work comp drug talk round 2
Read More...Physicians and clinics are finding that dispensing drugs to patients can be a very profitable venture. Advocates are claiming that the practice improves the quality of care and ensures the patient receives the necessary scripts. Let’s take the quality of … Continue reading Repackagers’ margins
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