Research Papers

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.

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.

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.

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 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.