Work comp drug spend – profiteering rampant in LA FL and PA

WCRI’s webinar on interstate variations in drug funds reminds us that lax rules and absent legislators value taxpayers and employers thousands and thousands.

Slides are here – and are free to entry. The report itself is here – accessible free to members and a nominal price for non-members.

There’s a ten-fold variation throughout the 28 states studied by WCRI, with WI MN and MA round $22 in quarterly drug spend per declare, however LA and FL proper round $200. A far increased proportion of claimants get scripts within the two high-spend states than in these on the decrease finish – and I’ll wager most of these are from shelling out physicians and attorney-represented staff utilizing mail-order pharmacies.

WCRI checked out information from non-COVID claims lower than 3 years previous in 28 states from Q1 2018 to Q1 2021.

High takeaway – total quarterly drug funds dropped from $102 in Q1 2015 to $68 in Q1 2021 – however PA FL and CT – states with doctor shelling out and/or mail order pharmacy issues – really noticed a rise – and that improve was largely pushed by dermatological brokers.

Need extra proof of the rampant profiteering enabled by lax rules and compromised legislators?

  • Dermatological funds account for about 20% of funds within the median state – though there’s a large variation, from 6% within the lowest state to over half (52%) of funds within the highest state.
  • These dermatological brokers are nearly at all times combos of lidocaine, menthol, diclofenac sodium and different generics – profiteers combine ’em up and invoice at an enormous markup.
  • PA is particularly egregious – the overwhelming majority of those dermatologicals are pharmacy-dispensed, and the typical worth paid was over $300.
  • Doctor disbursed medicine accounted for greater than half of drug prices in a number of states together with Florida
  • It’s not simply dermatologicals…California noticed a giant leap in NSAIDS pushed by fenoprofen and ketoprofen…each questionable medicines which have develop into darlings of the doctor shelling out/mail order profiteers.

There’s excellent news too…after dermos, NSAIDs have the following highest cost throughout all drug teams at 18%…whereas opioids account for about 7% within the median states – method down from 13% in the identical quarter three years in the past.

I’d notice that that is for claims <3 years previous, and sure displays the profitable effort to keep away from prescribing opioids to sufferers higher served by different therapies.

What does this imply for you?

PA FL LA and CT  – cease screwing employers and taxpayers.



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