Part 3 of Coventry’s First Script Drug Trends Report Series is out for you. Most notably, it appears that opioid spend decreased between 2015 and 2016, likely due to a decrease in utilization as the industry looks into other alternatives for pain management. The report also looked at compound medications, a type of drug that has received a lot of attention in work comp and another that is used for pain management.
The data comes from all the 2016 bills that go through First Script’s Pharmacy Benefit Management program and bill review transactions.
They found that opioids declined in utilization, 10.7 percent, which also meant a 10.7 percent decrease in cost per claim. Total cost per claim, including managed and unmanaged usage, dropped 8.4 percent.
In managed prescriptions there were five opioids which accounted for 78.3 percent of opioid utilization, also accounting for 60 percent of the cost of all opioids. There was a 12.5 decrease in cost per claim for opioids compared to 2015’s data. In unmanaged prescriptions, extended-release tramadol saw its utilization drop 29 percent and 32.6 percent in terms of cost per claim.
Authors of the study pointed out that opioid utilization and costs have improved overall, but variations in claim age and severity of injury have driven differences in prescription filling for the managed and unmanaged population of injured workers. Managed prescriptions tend to be older and have greater severity.
On the managed side of things the number of injured workers using compounds is down to 1 percent, almost half of what it was the year before. Compound costs also dropped from 2015 and make up 2.5 percent of total drug spend. In unmanaged care, 3.1 percent of injured workers are using compounds but that is a 25 percent decrease from 2015. Compound costs in unmanaged views dropped from 31.9 percent in 2015 to 26.1 percent.