In the 14 years I’ve been surveying work comp payers on their views on pharmacy, I’ve never seen so little consensus among respondents on emerging issues.
In past years, compounds, physician dispensing, opioids, price inflation and new drug introductions have all been named by at least a plurality of respondents. Not so this year.
Here are some of the 24 respondents’ concerns:
While payers are seeing good success in reducing opioid utilization and total drug spend, there are a host of troubling issues out there.
Here’s why this is a big issue.
Payers are all too used to getting screwed by unethical and very creative profiteers intent on sucking money away from employers and taxpayers by exploiting loopholes. Branded topicals, “independent” mail order pharmacies and novel drugs are all great examples of these tactics, often hidden under, and supported by, claims that these promote healing and health despite a total lack of supporting evidence.
In past years when doctor dispensing, the opioid crisis or compounds were top-of-mind for most respondents, the industry joined together to come up with solutions. That obviously isn’t the case today, leaving patients exposed to crappy providers interested only in profits coming up with myriad ways to game the system.
What does this mean for you?
It’s not the one big problem that’ll get you, it’s the many small ones you may not even notice.
Joe Paduda is co-owner of CompPharma, a consortium of pharmacy benefit managers. This column is republished with his permission from his Managed Care Matters blog.
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