Drug costs per comp claim decline in most states: WCRI

Prescription payments per medical claim decreased by 15% or more in many states, but per claim payments remain high in some areas of the country, according to a report released Tuesday by the Workers Compensation Research Institute.

In its study of pharmaceutical costs per workers compensation claim in 28 states, the Cambridge, Massachusetts-based WCRI found that states saw the median prescription drug payments decline 41% between first-quarter 2017 through first-quarter 2021.

While the states of Arkansas, California and Kentucky reported declines by more than 50% in prescription payments per workers comp claim during that time period, Connecticut’s payment share rose 30% and Florida’s rose 5%.

States spent the most on dermatological agents, from $7 per claim in Iowa to $190 per claim in Louisiana between first-quarter 2017 and first-quarter 2020, with physician dispensing accounting for the majority of payments in 12 of the 28 states.

The second-most-utilized drug group, non-steroidal anti-inflammatories, saw per-claim payment vary from $21 in Delaware to $126 in Louisiana.

The decreased use of opioids in the workers compensation system also continued among study states, but the per-claim payment reduction for opioids ranged from a 40% drop in Louisiana to 81% in California.

The study includes Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin.

This article was first published in Business Insurance.

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