February 4, 2019 by WorkCompWire
Boca Raton, FL – NCCI recently announced the release of the 2018 update to its research brief, Workers Compensation and Prescription Drugs, which breaks down the major factors that make up overall prescription drug costs for the industry.
NCCI periodically analyzes the factors influencing prescription drug costs such as physician dispensing, opioid use, brand name vs. generic drugs, and in-network vs. out-of-network costs. The study reports on the most recent trends observed in the use of prescription drugs in WC.
Prescription drug costs make up 13%–14% of an overall workers compensation claim, on average. That’s been the case for many years now. However, behind those numbers something interesting is happening: the price of drugs continues to rise, but we’re using fewer of them.
Among the findings:
- The projected prescription drug share of total medical costs for Accident Year 2016 is 13.7%.
- Prescription drug costs per active claim have declined in 2015 and 2016 by 2% and 4%, respectively.
- Utilization is the main contributor to the decreases in 2015 and 2016.
- Prescription drug prices continue to rise, albeit at a slower rate than in previous years.
- Opioid costs per active claim have declined in 2015 and 2016 by 3% and 7%, respectively. Such decreases are due to lower utilization.
- Physician dispensing and brand name costs per active claim have also declined in 2015 and 2016. These decreases are due to lower utilization as well.
- In-network prescription drug costs are lower than those out-of-network.
- On average, brand name prescription drug prices have increased more than 10% per year in each of the last five years—with a cumulative increase of 80% since 2011.
- The top three drugs—Lyrica, OxyContin, and Gabapentin—account for more than 15% of prescription drug costs in 2016.
Major Topics in the brief include:
- The estimated accident year prescription drug share of WC costs overall and by state
- The impact of price and utilization changes on prescription drug costs
Read the free brief here: NCCI: Workers’ Compensation & Prescription Drugs – 2018 Update