White Paper
Unmasking the Silent Epidemic: The True Cost of Physician-Dispensed Topicals in Workers’ Comp
White Paper Summary
Few regulatory problems in workers’ compensation are as costly as physician-dispensed topicals.
These drugs, which doctors often give injured workers to take home after an office visit, are costly and oftentimes have lower-cost alternatives. These costs are burdensome for workers’ compensation payers and can ripple throughout the medical system.
During the pandemic, the practice became slightly less common with the decline of in-person office visits, but now it is back to pre-pandemic levels.
Physicians who dispense topicals may be taking advantage of a lack of regulation to sell drugs they believe are safe — albeit no more effective than retail medications — at a premium. Few states have regulations on physician dispensing, allowing it to grow and add to costs. PBMs are lobbying to change laws on a state-by-state basis, but there’s little they can do in the interim, as the practice falls outside of their review process.
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