White Paper

High Prices, High Impact: Meet the Drugs Driving Up Claim Costs in Workers’ Comp

High-impact drugs represent proportionately low utilization compared to opioids or NSAIDs, but they can increase pharmacy spend exponentially on impacted claims.

White Paper Summary

A Healthesystems survey of workers’ comp stakeholders shows that containing costs is the top pharmacy program goal for 57 percent of respondents, making it their #1 pharmacy program goal overall. Additionally, medical price inflation, including pharmacy price inflation, remains a challenge for 44 percent of stakeholders.

This focus on pharmacy costs may be spurred by increases in utilization and cost for specific drugs, including some that come with high price tags and sometimes questionable clinical benefits. These high-impact drugs – which include dermatologicals/topicals, compounds, and more – are a mix of long-standing classes and more emerging trends. While they each represent proportionately low utilization compared to opioids or NSAIDs, their high prices can increase the cost of individual claims exponentially.

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

Healthesystems is a leading provider of Pharmacy Benefit Management (PBM) & Ancillary Benefits Management programs for the workers' compensation industry.

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