WI: Cost Per Claim of Drugs Prescribed to Injured Workers Was 30 Percent Lower Than Study Median

WI: Cost Per Claim of Drugs Prescribed to Injured Workers Was 30 Percent Lower Than Study Median

CAMBRIDGE, MA - The cost per claim of prescription drugs used to treat injured workers in Wisconsin was significantly lower than in most study states, according to a new study 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 Wisconsin workers’ compensation system was $288—30 percent lower than the median of the study states.

The main reasons for the lower prescription costs in Wisconsin include lower prices paid to pharmacies for most common drugs, more frequent use of less expensive generic drugs, and fewer prescriptions per claim, especially for some commonly used narcotics.

The WCRI study, Prescription Benchmarks for Wisconsin, found that the average price paid to pharmacies in Wisconsin was 15 percent lower than in the median state. The average prices paid to pharmacies in Wisconsin were lower for some common drugs, but fairly typical for other common drugs.

Wisconsin physicians more often prescribed generics to substitute for more expensive brand name drugs. Brand name medications accounted for 11 percent of all prescriptions, compared with 15 percent in the median state, according to the study.

The study also found that the utilization of prescription drugs in Wisconsin was lower compared to most study states. The average number of prescriptions per claim in Wisconsin was 14 percent lower while the average number of pills per claim was 12 percent lower than the 16-state median. This was mainly because Wisconsin physicians wrote and workers filled fewer prescriptions per claim, especially for common drugs such as the painkillers Vicodin®, OxyContin® and Darvoset-N®.

The report also noted that some Wisconsin physicians wrote and dispensed medications directly to the patient. Physician-dispensed prescriptions accounted for only 7 percent of all prescriptions in Wisconsin. Physician dispensing prescription drugs did not appear to be a cost driver of prescription drugs for Wisconsin, according to the study.

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: WCRI