CAMBRIDGE, MA - The cost per claim of prescription drugs used to treat injured workers in Pennsylvania was slightly higher than most study states in a new report by the Workers Compensation Research Institute (WCRI).
The 16-state study by the Cambridge, MA-based WCRI found that the average payment per claim for prescription drugs in the Pennsylvania workers’ compensation system was $445—8 percent higher than the median of the study states.
The average price per pill paid to pharmacies was slightly higher than the median of the 16 study states, largely due to more frequent prescriptions of expensive brand name drugs, according to the WCRI study, Prescription Benchmarks for Pennsylvania.
Pennsylvania physicians prescribed more expensive brand name drugs for 18 percent of all prescriptions compared to 15 percent in the median state. Fifteen percent of all prescriptions prescribed by Pennsylvania physicians were those brand names where less expensive generic equivalents were available, compared to 13 percent in the median state.
Prices paid to pharmacies for the most common medications used to treat injured workers in Pennsylvania were similar to the median state despite Pennsylvania’s higher pharmacy fee schedule that is set to 10 percent above the Average Wholesale Price.
The utilization of prescription drugs in Pennsylvania was typical of the 16 states, reflected in the average number of pills per claim and the average number of prescriptions per claim, the study reports.
The study also noted that some physicians wrote and dispensed prescriptions at their offices directly to the patient. When Pennsylvania physicians dispensed commonly used drugs, the average prices paid to physician-dispensers were often higher than what pharmacies would have been paid for the same prescription.
The WCRI study is the first in an annual series that benchmarks the cost, price and utilization of pharmaceuticals in workers’ compensation.
The Workers Compensation Research Institute is a nonpartisan, not-for-profit membership organization conducting public policy research on workers’ compensation, healthcare and disability issues. Its members include employers, insurers, insurance regulators and state administrative agencies in the U.S., Canada, Australia and New Zealand as well as several state labor organizations.
To order this report, go to the WCRI web site: www.wcrinet.org.
Source: Workers Compensation Research Institute