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NCCI study shows medication costs in work comp cases are rising

Employees who suffered a serious work injury will likely incur a variety of work comp medical expenses, including prescription medication costs. Interestingly, a recent study has revealed that these prescription medication costs are rapidly rising both here in California and across the entire nation.

According to the National Council on Compensation Insurance (NCCI), the average cost of prescription medication per claim rose by 12 percent in 2009 - the most recent year for which full data is available.

What then is driving up the cost of prescription medications in work comp claims?

The NCCI places much of the blame squarely on utilization.

"Utilization is one of two things," said NCCI researcher John Robertson. "One is the number of drugs dispensed. The other is the mix - if it goes from less expensive drugs to more expensive drugs for the same condition, that would get picked up in utilization."

In fact, the NCCI attributed much of this rise in utilization to more physicians dispensing medications themselves as opposed to pharmacies, where patients can get larger quantities of drugs for a lower cost.

"We knew that California had taken some steps to reduce the amount of repackaged drugs sold [by physicians], and we kind of expected the repackagers would try to start selling them in other states," said Robertson. "I personally had expected it to be a few states. I was surprised to find it was practically every state."

Indeed, the NCCI found that only four states - Rhode Island, Idaho, Oregon and Hawaii - saw a decline in physician dispensing in 2009.

Interestingly, the study also rated the top five most prescribed drugs for work injuries. They included the following:

  1. OxyContin
  2. Lidoderm
  3. Hydrocodone-acetaminophen (Vicodin)
  4. Lyrica
  5. Celebrex

Stay tuned for further developments in the area of workers' compensation defense law...

This post was provided for informational purposes only and is not to be construed as legal advice.


Risk & Insurance, "NCCI: Physician dispensing on the rise in most states" Oct. 6, 2011

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