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Workers Comp Pharmaceutical Concerns Focus on Pain Killer Abuse

Study Finds that Pain Killer Abuse at Top of Workers Comp Concern List, Will Be Addressed in National Rx Abuse Summit

A survey released in January from CompPharma, LLC – a consortium of workers comp pharmacy benefit managers – found that opioid pain killer abuse was the top of the list of workers comp cost drivers.

The 2012 Survey of Prescription Drug Management was a nine-year-long survey of costs and concerns in the workers comp pharmacy industry. The survey states, “Pharmacy management does not occur in a vacuum. Outside factors profoundly affect pharmacy in workers compensation, factors that include societal issues, e.g. the explosive growth in opioid abuse.”

Survey respondents were decision-makers and operations staff of 18 workers’ compensation insurance carriers or third-party administrators. These companies’ total prescription expenses amounted to $473 million, 12% of total estimated workers’ compensation drug spending.

The survey goes on to discuss drug costs in workers comp overall. “Despite relatively flat drug costs, respondents continue to be significantly concerned about the issue. In response to the question ‘How big a problem are drug costs?’ on a 1 through 5 scale with 3 being ‘drug costs are equally as important as other medical cost issues,’ drug costs were rated a 4.1, or ‘more important than other medical cost issues.’”

Respondents said opioid pain killers, like hydrocodone and oxycodone, were the biggest problem in workers’ compensation pharmacy management and most had implemented programs to address opioid overuse and abuse. These programs included nurses conducting specialty reviews, pharmacists contacting treating physicians, physician peer-to-peer contact, urine drug testing, education on proper dosage and monitoring and increased use of WC-PBM drug utilization, fraud and abuse programs.

A February study from the California Workers Compensation Institute found similar pharmaceutical concerns regarding workers compensation. According to that survey, medical benefits for California workers comp claims that included physician-dispensed medications, including pain killers, cost 17% more than claims which do not include medications.

National Rx Abuse Summit Will Focus on Workers Comp-Related Pain Killer Abuse

This finding comes amid national concern about workers comp fraud, as well as a growing problem of prescription drug addiction and abuse. The FDA recently received a report from an advisory committee that recommended reclassifying hydrocodone, an opioid pain medication, as a Schedule II drug, putting it in the same strict regulatory category as oxycodone and related drugs. The hope is that the tighter controls would slow the problem of prescription pain killer abuse, but that means doctors would also have a tougher time prescribing and dispensing medically necessary medication, including to patients who need the help while surviving on workers comp benefits.

The CDC found recently that 2010 saw the 11th consecutive year that drug overdose deaths rose. Opioid pain medication overdoses were no exception – they rose on a similar curve. “In 2010, nearly 60 percent of the drug overdose deaths (22,134) involved pharmaceutical drugs. Opioid analgesics, such as oxycodone, hydrocodone, and methadone, were involved in about 3 of every 4 pharmaceutical overdose deaths (16,651), confirming the predominant role opioid analgesics play in drug overdose deaths.”

The workers comp industry will spotlight the fight against pain killer abuse in the 2013 National Rx Drug Abuse Summit, in Orlando, FL. The Third-Party Payer Track will focus on identifying potential pain killer abuse early in an injured worker’s treatment. According to a press release, “Sessions stress using analytics and diagnostic testing to track and reduce an injured employee’s addiction potential, improve health outcomes and contain comp claims costs.  Discussions include pain management alternatives to opioids, such as cognitive behavior therapy and functional restoration, and using medical and legal strategies like utilization review and independent medical exams to ensure injured workers do not continue receiving drugs they don’t need.  One session highlights successful regulatory and legislative efforts to control opioid abuse undertaken by the states of Texas and Washington.”

It is crucial for workers comp legislation and insurance across the nation to find a solution to the problem, to help resolve accusations of workers comp abuse, as well as lower costs for insurance and corporations.

The Strom Law Firm Understands Worker’s Comp Legislation

The work-injury lawyers at The Strom Law Firm, LLC proudly seek justice on behalf of employees injured or killed on the job who work for private companies, as well as employees working for local county, city, and state government. We are licensed to practice throughout South Carolina, as well as Georgia and New York. If you are confused about worker’s comp laws, or have had your worker’s comp claim denied, contact us. We offer free consultations to discuss the facts of your case. 803.252.4800.



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