I’ll be releasing the fourth annual survey of prescription drug management in workers comp in a few weeks. Here are a few early findings.
Drug spend appears to be moderating, for two reasons. Payers are experiencing a decline in claims volume and the more sophisticated payers are starting to see success in their utilization management programs.
Third party billers are still a problem – that’s not news, but what is news is the wide spectrum of solutions to the TPB issue. At one end are the payers that are refusing outright to pay them anything on any scripts, and at the other are the payers that are in negotiations to pay the third party billers to send scripts to them and then convert them to their PBM program.
The level of concern about overuse of pain medications is at an all time high. Respondents are frustrated with physicians who they perceive to start treating pain with heavy-duty narcotic opioids (instead of trying other solutions first).
Card programs are gaining favor, in part due to payer frustrations with third party billers.
More to come…
