White Paper

myMatrixx 2019 Drug Trend Report

Each year, myMatrixx releases our Drug Trend Report to track the utilization and costs of pharmaceuticals used in WC cases. By looking back at the previous year we can better help our partners understand the primary factors driving the industry.
By:

White Paper Summary

Workers’ compensation pharmacy spending decreased by 6.1% in 2019, according to new data released today by myMatrixx. Through customized solutions that focus on patient safety and clinical care, myMatrixx provides monitoring and clinical intervention at all phases during the life of a workers’ compensation claim.

“Helping our clients balance appropriate care for injured workers while responsibly keeping costs down is the most important thing we can do for workers hurt on the job,” said Mike Cirillo, President, myMatrixx. “With our nation facing the COVID-19 pandemic, more attention is being paid to those on the front line who are at the heart of our industry, including health care, manufacturing and delivery workers. The myMatrixx team remains focused on these workers and their employers each and every day.”

In 2019, payers with a workers’ compensation program managed by myMatrixx experienced a 6.1% decline in total costs and a 4.3% decrease in the number of prescriptions. At the injured patient level, prescription drug costs decreased 2.4% even though utilization increased 1.9%, which highlights the impact of the trend we have identified as the Age of Claim effect.

Improving Spend and Safety of Opioid Use
By leveraging data to create proactive points of intervention, educating injured workers and ensuring connectivity across the care continuum, myMatrixx has continued to implement strategies to protect injured workers from the misuse and abuse of opioids. Average spending on opioids declined by 10.7% for payers between 2018 and 2019. In fact, overall payer spend on opioids between 2015 and 2019 declined 45.1%. In addition, injured workers are taking opioids for shorter periods of time. In 2019, 14.7% of injured workers used opioids for 30 or more days, down from 17.0% in 2018.

Generic Substitution Yields Savings
Generic substitution remained a cornerstone of myMatrixx’s strategy to offset the cost of name brand prescriptions which saw list price inflation of 70.5% from 2014-2019. A primary driver of generic savings was the launch of pregabalin, the generic version of Lyrica®, used to treat neuropathic pain. Aggressive substitution strategies assured that payers received maximum benefit as soon as possible.

Other Key Findings of the Workers’ Compensation Drug Trend Report include:

An increase in the use of private-label topicals. These products are marketed to and distributed only by prescribers, but they are driving significant costs, often with little to no therapeutic advantage over traditional topical products available through our retail pharmacy network.

Specialty therapy costs in workers’ compensation continued to increase in 2019, with an 18% increase in spend and a 27.0% increase in utilization. Note that the biggest impact from generic substitution in coming years may be within this market.

With an increase in the median workforce age, 40.4% of injured workers were age 55+ in 2019.

myMatrixx has identified this trend as the Age of Patient effect and consults with prescribers frequently regarding drug therapy management for senior patients.

To learn more about myMatrixx, please visit their website.

myMatrixx® is a pharmacy benefit management company dedicated to workers’ compensation. The unique combination of myMatrixx and Express Scripts makes us the only workers’ compensation pharmacy benefit manager that can deliver high touch customer service, clinical expertise and actionable data analytics while leveraging Express Scripts’ pharmacy network, comprehensive clinical services, mail order program and specialty solutions to meet the individual needs of our clients and their injured workers. For more information, visit myMatrixx.com.

More from Risk & Insurance

More from Risk & Insurance

Risk Matrix: Presented by Liberty Mutual Insurance

9 Trends that Are Driving Rate Increases

The market was optimistically cautious entering 2020, but thanks to COVID-19, growing liability challenges and other risk factors, we’re seeing more hardening.
By: | September 1, 2020




The R&I Editorial Team can be reached at [email protected]