2023 Demystifying Drug Pricing Series Part Three (The Impact of Specialty Drugs)Download
2023 Demystifying Drug Pricing Series Part Two (Examining the Impact of Opioids on Drug Spend)Download
2023 Demystifying Drug Pricing Series Part One (A Closer Look at the Traditional Prescription Drug Market)
Over the years, drug manufacturers have increased list prices, which has affected nearly every American. Some patients must weigh the costs of needed medications against the costs of other essentials. As with other goods and services, determining the price of pharmaceuticals is an intricate process based on supply and demand, research and development costs, federal and state regulations, and patent laws. With this topic continuing to receive coverage in the media in regard to general health care, we've launched our 2023 Demystifying Drug Pricing white paper series to provide education and clarity on drug pricing as it pertains to workers’ compensation pharmaceuticals.
Get access to part one of our new series to get a behind-the-scenes look at the traditional prescription drug market and learn how to adopt effective cost-reduction strategies to enhance your workers' compensation program.
Electronic Prescribing in Workers’ Compensation — Current Trends, Barriers to Adoption, and Opportunities for Innovation
While electronic prescribing has become the norm in group health care, the adoption rate within workers’ compensation has been slow. Phil Walls, Chief Clinical Officer, uncovers some of the barriers to adoption in workers’ compensation, the benefits of continued implementation and the advanced innovative opportunities e-prescribing can help us achieve: patient safety, convenience and value to payers. Along with insights from Surescripts and the Surescripts Network Alliance, we are able to see the positive impact it has had in group health and the ways it can help address long-stand issues and inefficiencies in this industry.
We invite you to read more about the current state and future of electronic prescribing in workers’ comp.
Lifting the Manual Burden: How Advanced Automation and Decision Intelligence Can Transform Workflows
Creating efficiencies in today’s workforce is more important than ever. Factoring in various world events – COVID, labor shortages, an aging population and a turbulent economy – companies, especially in workers’ comp, should be looking towards technology and innovation to assist in complex decision-making situations to free up time for more strategic patient outcomes.
In a recently released paper, Cliff Belliveau (myMatrixx VP, Business Intelligence) and Hollie Lamboy (myMatrixx Sr. VP, Product Development) talk through automation and the power of data to streamline workflows and improve efficiencies for claims professionals.
Demystifying Drug Pricing in Workers' Comp (Part One)
When discussing the growing cost of drugs, we tend to frame the topic around name-brand versus generic drugs, with a view that despite the cost-saving opportunities of generics, overall spending on drugs continues to increase. However, segmenting the drug market into categories beyond purely brand versus generic drugs enables us to more accurately identify the major trends and drivers for drug prices in workers’ compensation. It is possible for drug spending to decline even when drug prices are increasing based on enhanced patient outcomes resulting from clinical pharmacy management and changes in claim counts and injury severity.
In part one, we will provide an overview of three of the most important market segments driving pharmaceutical spending: the specialty drug market, compounding and physician dispensing. Coming soon for part two of this report, we will examine the overall pharmaceutical market looking at trends impacting price and utilization.
The Future of Pharmacy Solutions and The Impacts on Workers’ Compensation
As the pharmaceutical industry continues to take on an expanding role in the development of breakthrough medication, pharmacy solutions organizations will be just as essential in ensuring their delivery. Published in partnership with myMatrixx parent company, Cigna, this paper discusses the critical work these entities, which include workers’ compensation PBMs, need to do to deliver therapies to the correct patients, at the right time, in the appropriate setting and at affordable costs. Specifically, myMatrixx Chief Clinical Officer, Phil Walls, covers this topic from a workers’ compensation perspective, sharing how much an aging population with a growing list of comorbidities is affecting the cost and safe delivery of drug therapy for injured workers while also emphasizing the ongoing role of generic substitution.
2020 Workers’ Compensation Drug Trend Report
myMatrixx releases its annual Drug Trend Report as a comprehensive analysis of the major drivers in the sector of workers’ compensation retail pharmacy. Delivering the report in 2021 required an examination of truly unprecedented circumstances of 2020. The emerging COVID-19 pandemic affected every industry, including workers’ compensation.
This year’s report covers the effect of COVID-19 on workers’ compensation pharmacy, as well as a continued focus on ongoing issues including opioid misuse, an aging workforce and the growing role of behavioral care. Despite a turbulent year, this report demonstrates an ongoing commitment to positive outcomes for injured workers and effective cost management of prescription drugs for payers.
COVID-19 Vaccination, Treatment and Coverage under Workers’ Compensation
Workers’ compensation has not traditionally paid for the cost of preventative care, including vaccinations, and this is expected to continue to be the case for the COVID-19 vaccinations. Any costs associated with the vaccine and its administration are expected to be covered by public or private insurance. However, there are worker populations who may require vaccination under certain COVID presumption laws and other proposed regulations.
The aim of this position paper is to provide detailed information about the COVID-19 vaccinations from a workers’ compensation perspective. This includes formulary considerations, vaccine immunity, vaccine availability, emergence of new COVID-19 variants and resources for additional information.