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Express Scripts Research Shows Choosing Appropriate Medications Could Save Workers' Compensation Pay

Executive Summary

Categories: » Workers’ Comp & Disability
»» Claims Management
»» Cost Containment
»» Medical Bill Review
»» Pharmacy Benefits Management

Abstract

Choosing clinically equivalent, lower-cost narcotic medications could cut more than $23 million a year in pharmacy-related costs for workers' compensation claims, according to an Express Scripts analysis. ...

Published: 03/19/2012

ST. LOUIS, MARCH 19 – Choosing clinically equivalent, lower-cost narcotic medications could cut more than $23 million a year in pharmacy-related costs for workers’ compensation claims, according to an Express Scripts, Inc. (NASDAQ: ESRX) analysis.

Express Scripts researchers examined workers’ compensation prescription data for 402,000 injured workers, who had filled at least one narcotic prescription from 2002 to 2010. A comparison of narcotic prescribing practices found that in some instances, injured workers were initially prescribed more expensive, nonmorphine-containing long-acting drugs, such as oxymorphone or oxycodone to treat their pain.

Long-acting narcotics are designed to release the medication over time to provide pain relief for chronic pain. These medications shouldn’t typically be the first course of treatment in treating a work-related injury, said Tim Pokorney, clinical director of workers’ compensation at Express Scripts. They can be added, with proper monitoring and risk assessment, if pain persists. In most work-related injury cases, short-acting narcotics containing oxycodone/acetaminophen or hydrocodone/acetaminophen are the appropriate first course of treatment.

“Additionally, when long-acting narcotics are added to therapy, medications that contain morphine can be just as effective as long-acting drugs that contain other narcotics. They are also lower in cost and carry no additional risk of addiction,” Pokorney said.

According to the data analyzed, the average cost of nonmorphine-containing narcotics is $9.83 per therapy day compared to $6.62 for morphine-containing medications. Choosing these more expensive medications over morphine-containing medications could amount to $1,172 in additional spending per injured worker each year they use narcotic medication. Of the prescriptions in the study, 20,220 injured workers initiated therapy on a nonmorphine-containing, long-acting narcotic or added a nonmorphine, long-acting

narcotic to therapy without trying a morphine-containing drug first. The total additional cost for payers could be as high as $23.7 million.

Express Scripts’ analysis also showed that the cost of medications used to treat pain for injured workers using nonmorphine-containing, long-acting narcotics was higher and increased more quickly than the cost for injured workers using morphine-containing long-acting narcotics. Approximately 18 percent of treatment expense for workers’ compensation patients is attributed to prescription drugs. According to the Express Scripts 2010 Workers’ Compensation Drug Trend Report, narcotics accounted for more than one-third of pharmacy costs for injured workers.

Express Scripts has several programs in place to help payers control escalating prescription costs for work-related injuries. The company takes a multi-faceted approach to managing narcotics, including early intervention reporting, point-of-sale edits and physician communications.

About Express Scripts
Express Scripts, Inc., one of the largest pharmacy benefit management companies in North America, is leading the way toward creating better health and value for patients through Consumerology®, the advanced application of the behavioral sciences to healthcare. This approach is helping millions of patients realize greater healthcare outcomes and lowering cost by assisting in influencing their behavior. Headquartered in St. Louis, Express Scripts provides integrated PBM services including network-pharmacy claims processing, home delivery services, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services. The company also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services. More information can be found at http://www.express-scripts.com/pressroom/.


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