Drug Pricing Legislation and Its Impact on Workers’ Comp

White Paper Summary

High prescription drug prices have concerned American consumers, and therefore American lawmakers, for decades. And there is good reason for those concerns. Prescription drug prices in the U.S. are almost three times higher than in other countries, and the average manufacturer drug price increase from 2022-23 was over 15%. Since 1980, U.S. spending on prescription drugs increased from $30 billion to $435 billion in 2023, although the total spend accounts for an increase in utilization, as well as prices.

This is in contrast to workers’ compensation, where drug spending has been trending downward for more than a decade, mainly due to a combination of clinical and cost management strategies. The bulk of prescription drugs are purchased under group health insurance, including government and commercial plans, and both drug prices and utilization are on the rise for this sector. Their members, also known as healthcare consumers, are directly impacted by high drug prices, and 82% of them say prescription drugs cost too much.

In response to consumers’ (also known as constituents) concerns, lawmakers have attempted to address the drug price issue in various ways. These efforts have historically been – and still are – motivated by the desire to reduce costs for individual patients, focusing on the way drugs are paid for under Medicare and commercial health plans.

For more content like this from Healthesystems visit their RxInformer clinical journal website.