By Phil Yacuboski
Sarasota, FL (WorkersCompensation.com) - The prescription of generic drugs is trending upward in workers’ compensation, according to research released by Coventry Workers’ Comp Services. The research looked at both managed and unmanaged prescriptions in cases from 2015-2016.
According to the report, generic drugs are prescribed more often than name brand products.
“It’s a trend that’s been out there for a while now,” said Dr. Randy Vogenberg, Principal with the Institute for Integrated Healthcare and co-founder of the National Institute of Collaborative Healthcare. “There’s nothing wrong with generic drugs. We’re well beyond that debate. The issue is the cost of a generic drug versus the cost of a brand drug.”
The price issue is what is driving this debate, he said.
“In generic drugs, you’re maybe down to one or two manufacturers. In essence, they are creating monopolies. The only way they can make money is to keep raising the price. It’s been out of control for some time. Workers’ comp is the least able to manage their exposure.”
He said because of the rules in place regarding workers’ comp in most states, doctors can write a prescription and “that’s it.”
“Whatever that costs, that’s what they (the insurance company) pay,” he said.
Pain management and musculoskeletal conditions are the two most common conditions treated in workers’ comp cases, according to Dr. Vogenberg.
The research by Coventry Workers’ Comp Services also found that while opioids are still the most prescribed drug, there was a decline in 2016 when costs associated with opioids dropped 1.4 percent from the previous year. Other drugs, however, are increasing like muscle relaxants and NSAIDs (nonsteroidal anti-inflammatory drugs).
“You don’t necessarily need a brand in those cases,” he said, adding that in some cases a doctor will combine two generic drugs into one prescription, thus creating a “brand” name. For more information on compound medications, click here for WorkersCompensation.com coverage.
The Workers’ Compensation Research Institute (WCRI), which conducts their own research, recently found that when it comes to opioids, there has been a reduction in those received by injured workers in 15 of the 26 states studied for the research.
“Larger reductions were seen in Kentucky, Maryland, Michigan and New York,” said Andrew Kenneally, communications director for the Workers Compensation Research Institute. He said the research does not attribute to specific reforms. “It does point to the changing landscape of policies addressing prescribing and dispensing of opioids.”
“Because of the different state laws and politics at the state level surrounding workers’ comp issues, it’s hard to put restrictions in around workers’ comp benefits,” Dr. Vogenberg said.
In Pennsylvania, a bill is working its way through the state legislature to create a state workers’ compensation drug formulary. The bill would create a “nationally recognized, evidence based drug formulary” to solve issues surrounding prescribed drugs and workers’ comp cases.
For more viewpoints and information on other states looking into formularies, or states that have already made the plunge, check out WorkersCompensation.com coverage here.
“It’s not for the benefit of the patient,” said Larry Chaban, a Pittsburgh workers’ compensation attorney. “My experience with formularies is that it’s for the benefit of the insurance company to reduce costs. Period.”
He also said in some cases the generic drugs don’t work and a patient is then prescribed a name brand drug.
“With state laws varying from state to state, having a national standard doesn’t seem to be an appropriate thing,” Chaban said.
