myMatrixx Reports U.S. Workers' Comp Plans Decreased Drug Spending in 2018

Apr 18, 2019

myMatrixx helped workers’ compensation plans reduce drug spending by 3.8% in 2018, according to the annual myMatrixx Drug Trend Report.

Workers Comp Drug Trend Report

Workers’ compensation pharmacy spending decreased 3.8 percent in 2018, according to the 13th annual myMatrixx Drug Trend Report. Through increased efforts to better manage opioid use, and encourage more appropriate therapies generally, we’re able to do more for injured workers and our clients.

For the first time, our report combines Express Scripts and myMatrixx data, providing a more comprehensive view of the industry than ever before.

In 2018, more than half (53.3 percent) of myMatrixx Workers’ Compensation plans reduced drug spending.

Improving Appropriate Opioid Treatment

We are committed to educating prescribers and reducing injured workers’ risk for opioid-related adverse events. myMatrixx has implemented solutions that leverage data to create proactive points of intervention and ensure connectivity across the care continuum. Our efforts to protect injured workers from the misuse and abuse of opioids appear to be working. Nearly 66 percent of workers’ compensation payers spent less on opioids in 2018 compared to 2017, and opioids have dropped to second place on the list of most commonly dispensed drugs for many payers.

Drug spend on opioids is down 40.4 percent since 2015. In 2018, average spending on opioids declined 15 percent for our workers’ compensation payers – the largest decrease yet -- from $313.40 per patient per year, to $268.88 per patient per year.

Avoiding the Next Possible Crisis

Prescribers are turning to non-opioid drugs for pain management. Our analysis indicates that non-steroidal anti-inflammatory drugs (NSAIDs) and gabapentin, the preferred alternatives for pain management, are the only pain medications with an increase in utilization among our payers. Other drugs of concern, such as benzodiazapines and sedative hypnotics, decreased in use, while use of other pain drugs showed no changes.

As our efforts to better manage the use of opioids have resulted in lowering risks for injured workers as well as lowering drug spend, we have not lost sight of the risks of other drugs of concern.

Our pharmacovigilance program monitors and combats excessively priced drugs, identifies potential fraud and abuse and has been a key factor in our 2018 results as we focus on addressing the unique needs of injured workers.

Better Management of Specialty Therapies

Spending on specialty medications – used to treat complex chronic conditions such as hepatitis C, HIV, and rheumatoid arthritis -- continues to rise across the healthcare industry. Workers’ compensation payers need to be prepared to manage these costs: spending on specialty medications increased 18.5 percent in 2018 among injured workers’ plans, and although just 1.7 percent of injured workers use a specialty drug, these claims account for 7.1 percent of spend.

In partnership with our sister company, Accredo, the nation's largest full-service specialty pharmacy, we are able to identify and deliver the best possible support for injured workers who need specialty medications by providing access to individualized clinical counseling for injured workers with the most complex conditions.

Click to download the report.

Author Bio

Phil Walls
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