myMatrixx Innovative Solutions Lowered U.S. Workers’ Compensation Plans Drug Spending by 3.8% in 2018

Posted on by myMatrixx

ST. LOUIS, April 18, 2019 – Through increased efforts to better manage opioid use, and encourage more appropriate therapies generally, myMatrixx helped workers’ compensation plans reduce drug spending by 3.8% in 2018, according to the annual myMatrixx Drug Trend Report released today.

For the report, prescription medication use between 2017 and 2018 was evaluated among injured workers in programs managed by myMatrixx, an Express Scripts company, to examine current and future prescription medication use trends for this population.

“Our efforts to manage utilization and lower costs are providing workers’ compensation plans with an effective combination of clinical and financial oversight,” said Mike Cirillo, president, myMatrixx. “We’re doing more to help clients balance appropriate care for injured workers while keeping costs down.”

In 2018, more than half (53.3%) of myMatrixx Workers’ Compensation plans reduced drug spending.

Unit costs per days’ supply of medications decreased by 0.9 percent in 2018, as a result of myMatrixx’s ability to deliver lowest net cost medications for plans, and greater use of lower-cost therapies by patients.

Use of compounded medications, once a source of great expense for injured workers’ plans, was nearly eliminated in 2018, as the usage is now just 0.2% due to continued proactive efforts across myMatrixx workers’ compensation payers to move patients away from these often high-cost medications to less expensive, clinically appropriate alternatives.

Improving Appropriate Opioid Treatment

Long focused on injured workers’ risk for opioid-related adverse events, myMatrixx has implemented solutions that leverage data to create proactive points of intervention, educate injured workers and ensure connectivity across the care continuum. Our efforts to protect injured workers from the misuse and abuse of opioids appear to be working. Nearly 66 percent of workers’ compensation payers spent less on opioids in 2018 compared to 2017.

The percent of injured workers using opioids for greater than 30 days also decreased, from 21 percent in 2017 to 17.6 percent in 2018. This is particularly significant as the data show that length of opioid use has a direct correlation on a plan’s average cost per injured worker. In the first year of opioid use, the average cost per person is $212.98. That cost jumps to nearly $4,000 per person when opioid use continues for up to 10 years.

Spending on opioids has declined for four consecutive years. In 2018, average spending on opioids declined 15 percent for our workers’ compensation payers – the largest decrease yet -- from $313.40 per patient per year, to $268.88 per patient per year.

Prescribers also are turning to non-opioid drugs for pain management. Our analysis indicates that non-steroidal anti-inflammatory drugs (NSAIDs) and gabapentin, the preferred alternatives for pain management, are the only pain medications with an increase in utilization among our payers. Other drugs of concern, such as benzodiazapines and sedative hypnotics, also decreased in use, while use of other pain drugs showed no changes.

Better Management of Specialty Therapies

Spending on specialty medications – used to treat complex chronic conditions such as hepatitis C, HIV, and rheumatoid arthritis -- continues to rise across the healthcare industry. Workers’ compensation payers need to be prepared to manage these costs: spending on specialty medications increased 18.5 percent in 2018 among injured workers’ plans, and although just 1.7 percent of injured workers use a specialty drug, these claims account for 7.1 percent of spend.

Payers who have injured workers with occupational exposure to needle-sticks often include HIV medications on their formulary to ensure quick access to work-related HIV prophylaxis therapy. This therapy class saw the highest spending among specialty medications. Worker populations that are most likely to encounters specialty medication claims include first responders, health care workers, and public safety personnel.

About myMatrixx, an Express Scripts company

myMatrixx is a full-service workers' compensation pharmacy benefit management company focused on patient advocacy. By combining agile technology, clinical expertise and advanced business analytics, myMatrixx simplifies workers' compensation claims management. Located in Tampa, Fla., myMatrixx has positioned itself as a thought leader in the workers' compensation industry.

myMatrixx is part of Express Scripts, a Cigna company. For more information, visit

Media Contact:

Christine Portell