ST. LOUIS, April 10, 2018 /PRNewswire/ -- Workers'
compensation pharmacy spending decreased 3.3 percent in 2017,
according to new data released by myMatrixx, an Express Scripts
(NASDAQ: ESRX) company.
"By merging the core capabilities of Express Scripts and
myMatrixx to deliver superior clinical expertise, market-leading
client experiences and innovative technology-based solutions,
myMatrixx is now uniquely positioned to serve workers' compensation
clients and injured workers," said Phil
Walls, RPh, Chief Clinical Officer for myMatrixx. "We're
doing more to help clients balance appropriate care for injured
workers while keeping costs down."
More than half of myMatrixx Workers' Compensation plans reduced
drug spending last year.
Curtailing the Opioid Epidemic
Spending on opioids declined 11.9 percent for workers'
compensation payers in 2017.
For decades, myMatrixx has championed safe and appropriate use
of opioids through solutions that leverage data, educate those at
risk for adverse events and ensure connectivity across the care
continuum. In addition, many states have taken action to address
the opioid crisis through a multifaceted approach involving
state-specific formularies, opioid guidelines and limits on initial
opioid dispensing days' supply and/or morphine equivalent dose.
These factors resulted in 74.2 percent of workers' compensation
payers spending less on opioids in 2017 than in 2016.
"While a decrease in the utilization of opioids is a positive
sign for the workers' compensation industry, there is still work to
be done," said Brigette Nelson,
senior vice president of workers' compensation clinical management
at myMatrixx.
myMatrixx research found dangerous drug combinations and
long-term use of opioids still pose care and cost concerns. Nearly
40 percent of injured workers took an opioid along with a muscle
relaxant, while nine percent took an opioid and benzodiazepine.
Taking these medications together can increase the risk of side
effects and death from respiratory depression.
By deploying a holistic approach to manage opioid use, myMatrixx
works with physicians, pharmacists and injured workers to mitigate
the concerns of drug interactions or overuse.
Additionally, myMatrixx noted by the eleventh year of injury,
the cost per injured worker reached $3,402.07, with $1,862.36 spent on opioid medications. Among
those with age of injury of 10 years or more, more than half filled
an opioid medication in 2017.
Compounded Medications Decline Further
For the third year in a row, spending on compounded medications
decreased – a decline of 37.9 percent in 2017, falling out of the
top 10 therapy classes.
While compounded medications continue to be a focus because of
their high cost, it is clear that effective management strategies
can reduce unnecessary costs and waste associated with clinically
unproven ingredients.
Specialty Medication Utilization Remains Low, but
Growing
Spending on specialty medications to treat conditions such as
HIV and osteoarthritis increased 3.8 percent in 2017. While these
drugs represent less than 1 percent of all medications used by
injured workers, the extreme high cost per prescription requires
payers to stay vigilant.
"Payers who have injured workers with occupational exposure to
needle-sticks often include HIV medications on their formulary to
ensure quick access to work-related HIV prophylaxis therapy,"
Nelson said. "This therapy class saw the highest spending among
specialty medications."
Other Key Findings of the Workers' Compensation Drug Trend
Report include:
- Generic fill rate increased to 85.6 percent across our workers'
compensation payers in 2017. Yet, payers could have saved
$80.8 million through an optimal mix
of clinically appropriate generic options.
- The average cost of a physician-dispensed medication was
$270.70, compared to $108.49 for a pharmacy-dispensed medication. This
means plans paid a $162 premium for
physician-dispensed medications which bypass pharmacist review at
the point of sale. Of the medications dispensed by physicians,
nearly half are used to treat pain.
- On average, payers spent $1421.36
per injured worker for prescription medications in 2017.
About the 2017 myMatrixx Drug Trend Report
The 2017 myMatrixx Workers' Compensation Drug Trend Report is
among the industry's most comprehensive analyses of workers'
compensation drug spending in the U.S. In its 12th
edition, the research examines de-identified prescription drug use
data of injured workers with a pharmacy benefit plan administered
by myMatrixx. The report also includes analysis of state and
federal government regulations and their impact on pharmacy-related
challenges in workers' compensation.
In calculating trend, prescription drug use was considered for
legacy Express Scripts clients with a stable injured-worker base,
defined as having a change in user volume of less than 50 percent
from 2016 to 2017.
The comprehensive review of trends in prescription drug
spending for workers' compensation plans is available at
myMatrixx.com
About myMatrixx, an Express Scripts company
myMatrixx® is a full-service workers compensation pharmacy
benefit management company focused on patient advocacy. By
combining agile technology, clinical expertise and advanced
business analytics, myMatrixx simplifies workers' compensation
claims management. Located in Tampa,
Florida, myMatrixx has positioned itself as a thought leader
in the workers' compensation industry.
For more information, visit myMatrixx.com
Media Contacts:
Phil
Blando
202-258-4978
PJBlando@express-scripts.com
Ellen Drazen
314-684-5355
EVDrazen@express-scripts.com
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SOURCE myMatrixx