The Texas Department of Insurance, Division of Workers’ Compensation (DWC) implemented a closed formulary in 2011 to manage prescription drugs for injured workers. The formulary excludes investigational, experimental and non-recommended or N-drugs, and requires pre-approval from insurers for compounds drugs. The DWC’s Workers’ Compensation Research and Evaluation Group (REG) released a study on the health outcomes of injured workers in terms of things like return-to-work rates since the formulary was implemented.

https://www.tdi.texas.gov/reports/wcreg/documents/formulary19.pdf

Since implementation the number of claims receiving pharmaceuticals decreased by 2 percent overall and the number of claims receiving N-drugs decreased 67 percent. The total number of prescriptions decreased by 11 percent and the total number of N-drug prescriptions decreased by 77 percent. The total number of claims receiving high levels of N-drug opioids creased from 15,000 in 2009 to less than 500 in 2015.

Total prescription costs have declined by 15 percent and the total cost of N-drug prescriptions decreased by 78 percent, while the average N-drug cost per claim decreased by 35 percent.

After the formulary took effect the average return-to-work rate increased for both network (from 90 to 94 percent) and non-network (from 87 to 90 percent) employees, as did the average physical functioning scores. The average mental functioning scores for network injured employees increased, but the average for non-network injured employees has stayed steady.

They found that 78 percent of workers got prescriptions they needed, and medical disputes decreased by 38 percent.

Read more here and check out the full study here.