Call or email us anytime
(805) 484-0333
Search Guide
Today is Saturday, July 13, 2024 -

Industry Insights

Paduda: The Latest on Workers' Comp Pharmacy

  • National
  • -  0 shares

We are finishing up our annual survey of pharmacy benefits management in workers’ comp. Here are three findings from the 15 we’ve done so far.

  • Joe Paduda

    Joe Paduda

    Sixty percent of respondents are reporting an increase in overall drug spend, with reasons varying from more claims to an uptick in catastrophic cases to jurisdictional impacts.

While we’re a long way from done and more respondent data is coming in, if the trend continues, this would be the second year of “non-decrease” in spend, signaling that the years-long drop in spend has stopped — and may have reversed.

  • Conversely, 80% of respondents are reporting lower opioid spend year over year.

If other respondents’ data is consistent, this marks the seventh consecutive year of a decrease, wonderful news, indeed, as patients and providers choose safer — and often more effective — solutions to pain.

  • Most respondents see a future for artificial intelligence in the PBM world, but the emphasis is definitely on the future.

There seems to be significant hesitation around implementing AI-based tools at this point. Ultimately, respondents see a range of “futures,” ranging from 100% automation of the entire process driven by AI to those who see AI focusing largely on early trend identification and clinical management improvements.

Public versions of our annual survey report are available for download here at no cost and no registration. Note that respondents get a much more detailed version of the report. 

Thanks to HSA’s Jay Stith and Helen Knight of CompPharma for their work on this year’s survey.

Joseph Paduda is the principal of Health Strategy Associates, a consulting firm focused on improving medical management programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.

No Comments

Log in to post a comment

Close


Do not post libelous remarks. You are solely responsible for the postings you input. By posting here you agree to hold harmless and indemnify WorkCompCentral for any damages and actions your post may cause.

Advertisements

Upcoming Events

  • Jul 29 – Aug 2, 2024

    76th Annual SAWCA Convention

    SAVE THE DATE! 76th Annual SAWCA Convention July 29 – August 2, 2024 Hotel Effie Sandestin 1 Grand …

  • Aug 14-17, 2024

    CSIMS 2024 Annual Dual Track C

    California Society of Industrial Medicine and Surgery (CSIMS) is combining its two conferences, PI …

  • Sep 23-26, 2024

    IAIABC 110th Convention

    The IAIABC invites you to the IAIABC 110th Convention, "Passport to Solutions". The IAIABC Convent …

Workers' Compensation Events

Social Media Links


WorkCompCentral
c/o Business Insurance Holdings, Inc.
PO Box 1010
Greenwich, CT 06836
(805) 484-0333