Coventry Releases Part 3 of 2017 First Script Drug Trends Report Series

Coventry released the third part of their 2017 Drug Trends Series, and this segment focuses on opioids and compounds which are closely watched topics in workers’ comp. The data from the series is based on calendar year transactions billed through their pharmacy benefit management (PBM) program First Script, and transactions from medical bill review.

They found that the aggregate (managed and unmanaged) overall prescription cost per claim decreased by 10.9 percent, while overall utilization per claim decreased by 8 percent. Opioid utilization per claim decreased 13.2 percent and cost per claim decreased 17.3 percent (partly because of the decrease in utilization). Total opioid cost decreased by 1.7 points, and total opioid prescriptions decreased by 1.4 points. Study authors attribute these reductions to patient and provider outreach programs, the use of risk-identification tools and clinical programs focused on reducing opioid use.

Overall, injured worker opioid utilization was down. Injured workers receiving managed prescriptions tended to have older claims, a higher severity of injuries and a larger percentage of claims receiving multiple fills of their prescriptions. Injured workers receiving unmanaged prescriptions typically received single prescriptions without refills and filled them at a clinic, emergency room, doctor’s office or hospital rather than a pharmacy.

Compound utilization per claim decreased 67.3 percent while compound costs per claim decreased 65.1 percent. Total compound costs decreased 4.7 points and total compound prescriptions decreased by 0.9 points. Compound medication costs fell for both managed and unmanaged groups and top states for compound utilization saw significant reductions in injured workers using compounds.

The study ended with recommendations going forward. They recommended monitoring other cost drivers that may increase as prescribers look for alternatives to opioids and compounds. Things like topical drugs and non-opioids pain management drugs are starting to trend upwards in cost and utilization and authors recommend tactics to determine appropriateness of these alternative therapies. They also recommend understanding the differences in filling managed and unmanaged prescriptions to build the best program for those individuals filling those kinds of prescriptions and ensure the best possible outcomes.

Read “Part 3” of the series from Coventry here.