Opioid spending in comp continues to decline

Workers compensation pharmacy costs continued to decline during the COVID-19 pandemic due to a steady reduction in opioid use, according to data released Wednesday by CompPharma LLC.

The Maggie Valley, North Carolina-based consulting company for pharmacy benefits managers surveyed those managing prescriptions for injured workers and found that despite reports of increased opioid use among workers comp patients during the COVID-19 year, survey respondents saw opioid spending drop to 17% of total comp drug spending, which was about $3 billion in 2020.

Workers comp opioid spending has gone down over 62% since 2016, according to data collected through CompPharma’s surveys, which also found that total workers comp pharmacy costs have decreased by 38% over the past decade.

Survey respondents credited the reduction in part to less use of opioids and the multiple medications needed to address opioid side effects. Other factors cited were California’s pharmacy fee schedule, a competitive PBM market and greater buying power that came from consolidation in the PBM industry, according to the statement.

Respondents, who represent state funds, insurers, self-insured employers, guarantee funds and third-party administrators, identified other emerging issues as PBM consolidation leading to poor service, less innovation and differentiation. Pricing transparency, physician dispensing and mail-order pharmacies were other concerns, according to the statement.

This article was first published in Business Insurance.

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