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Industry Insights

Paduda: Dramatic Changes

  • National

Work comp pharmacy has changed dramatically in the last 18 years.

Joe Paduda

Joe Paduda

Costs are much lower, brand drug usage has fallen off a cliff, pharmacy benefits managers are by far the dominant delivery channel, and there aren’t any real problems these days.

At least that’s what I’ve gleaned from doing 15 surveys of work comp execs on their perspectives and quantitative measures related to pharmacy.

Way back when:

  • Generic fill rates were around 70%.
  • generic efficiency was around 90%.
  • Cost inflation was in the mid-to-high single digits.

Expect that we’ll have the latest version of our annual survey in late January. In the meantime (and VERY preliminary):

  • Generic fill rates are around 90%.
  • Generic efficiency is north of 98%.
  • Inflation trends appear to be negative for about the seventh straight year.

Yet payers are still concerned about drugs, mostly because they are seen as major contributors to disability duration and recovery.

What does this mean for you?

It's not just the cost, it’s the knock-on effects. 

Joseph Paduda is co-owner of CompPharma, a consulting firm focused on improving pharmacy programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.

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