Research Papers

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.

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2020 Worker's Compensation Drug Trend Report Cover

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. 

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Covid-19 Position Paper Cover

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. 

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Preparing for the Boom: Is your Medical Management Program Primed for America’s Aging Workforce?

Preparing for the Boom: Is your Medical Management Program Primed for America’s Aging Workforce?

Many employers are beginning to experience the early trends of a growing number of employees choosing to stay in the workforce well beyond the traditional Social Security retirement age of 66 years and two months. This informative report shares the statistics and factors behind this trend, as well as the recommendations for preventing and managing work-related injuries among older workers.

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Specialty Drugs in Workers’ Compensation Update A Population-Based Assessment (2020 Update)

Specialty Drugs in Workers’ Compensation Update A Population-Based Assessment (2020 Update)

Specialty drugs are typically newer, complex, high-value medications that are rapidly becoming standard treatment for many rare and chronic conditions. According to Information Medical Statistics (IMS) Health, United States specialty net spending rose from 24.7% in 2008 to 46.5% in 2017. Specialty medicines are rapidly approaching half of total drug spend. Across all settings, specialty medicines treat relatively few patients and have costs far higher per patient than traditional medicines.

In this paper, myMatrixx will identify the significant patient populations where specialty drugs are the treatment of choice, including injured workers who have undergone orthopedic surgery, workers who have been exposed to HIV or hepatitis C, patients with conditions such as ankylosing spondylitis and rheumatoid arthritis as well as other key groups. Since these treatments also require enhanced clinical monitoring and medication management to ensure successful outcomes, this report will also cover the important role that pharmacy benefits managers play in this process.

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Facts about Naloxone: The Opioid Overdose Rescue Drug: a Clinical Brief Published August 2019

Facts about Naloxone: The Opioid Overdose Rescue Drug: a Clinical Brief Published August 2019

Naloxone is an opioid antagonist that blocks the effects of opioids and reverses an overdose. This medication is an essential tool that can be used in the event of an opioid overdose and has its role in the current opioid epidemic. While it is crucial to implement strategies toward reducing inappropriate use that leads to abuse and addiction in the first place, rescuing patients from overdoses will dramatically reduce mortality associated with opioid misuse.

For this reason, all 51 US jurisdictions have enacted naloxone access laws that remove varying levels of restrictions for naloxone. The next step however, appears to be the enactment of naloxone co-prescribing laws.

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The Opioid Crisis and Connecticut's Workforce

The Opioid Crisis and Connecticut's Workforce

As a person in recovery, it can be a very daunting task to re-enter the workforce. The stigma that surrounds addiction can be very negative and sometimes will prevent a person in recovery from even wanting to go through the hiring process. This document gives several recommendations regarding the tools that are needed by employers to properly navigate the complex world of workers dealing with addiction as well as those who are in recovery.

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It's Not Just Heroin Anymore: Evolving Role of Fentanyl in Drug Overdose

It's Not Just Heroin Anymore: Evolving Role of Fentanyl in Drug Overdose

Deaths from heroin overdose increased by a factor of five from 2010 to 2016. However, it has been reported in multiple outlets that many of these deaths are not caused by heroin alone, but instead involve illegally manufactured fentanyl, which can easily be mixed with white powder heroin. Currently, this latest danger in the opioid overdose epidemic has primarily been identified in states east of the Mississippi River. This geographic affect is because white powder heroin is not as prevalent west of the Mississippi where black tar heroin is the predominant form. The black tar heroin is not as easy to mix with fentanyl powder, and as a result, fentanyl is not as likely to be involved in an overdose west of the Mississippi.

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Compounds in Comp: A New Look at Patient Safety, Efficacy and Cost

Compounds in Comp: A New Look at Patient Safety, Efficacy and Cost

This paper seeks to clear up confusion surrounding compounding medications in workers' compensation. It clarifies research on the efficacy of compounds and explores how a pricing benchmark that was never intended to be applied to pharmaceutical grade chemicals has been manipulated to drive compounding prices and profits. We examine how certain business practices violate the traditional physician-patient-pharmacist triad, which has safeguarded patient interest for almost two centuries in this country. We also provide updates to legislative and regulatory actions addressing compounding in workers' compensation. Finally, we examine the consequences of what can most accurately be described as a greed-driven practice that has resulted in tragic deaths as well as the prosecution of numerous physicians and pharmacists.

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Creating An Advocacy-Based Claims Model

Creating An Advocacy-Based Claims Model

Business leaders in the healthcare industry invest significant time and resources to create positive corporate cultures, engage employees, and earn their trust and commitment to success. Yet in the workers’ compensation segment of our industry, all too often the focus seems to be on conflict instead of caring. We are in the business of delivering benefits…so, how do we get back to the basics of what workers’ compensation was founded on and change the conversation from adversary to advocate? How do we ensure that the treatment of injured workers aligns with our corporate values and culture? And how could changing the mindset from a cost protection model to a patient protection model improve outcomes--not only for injured workers but for employers as well?

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