TIP OF THE WEEK

July 16, 2010

Did you know...?

Initial Opioid Use Down, Costs Still Up

While the workers’ compensation industry has faced an uncertain year, one thing persists – medical and pharmacy costs continued to rise while claim frequencies decreased.

Medical costs increased on average 5 to 5.5% per year from 2004-2009.
Claim rates for workers’ compensation decreased 4.0% in 2009.
Pharmacy costs rose 6.5% in 2009.

These trends have necessitated a strong focus on the management of prescriptions to better control drug spending. To provide insight and analysis regarding these issues, PMSI publishes its Annual Drug Trends Report.

Some findings from their Annual Drug Trends Report include:

Initial use of opioid painkillers for the first time treatment of injured workers dropped in 2009 – but some experts warn the results may be a fluke and not a trend.
Retail and mail-order pharmacy transactions for last year showed the use of narcotic analgesics for treatment of new injuries in workers decreased 7.8% from the prior year, indicating that the potent opioids are being used less often as first-line agents to control pain.
The average pharmacy spending per injured worker increased 6.5% in 2009. The increase was driven by a 4.7% rise in prescription prices and a 1.7% increase in utilization.
Utilization changes were driven largely by a 2.2% increase in the “days of supply” per prescription from 27.6 days in 2008 to 28.2 days in 2009.
Spending for dermatologics increased from 3.1% of total expenditures in 2008 to 3.6% in 2009.

PMSI’s findings are based on a review of 5 million customer retail and mail-order transactions. The report excluded data for out-of-network pharmacy transactions.

A recent study by the National Council on Compensation Insurance (NCCI) shows narcotics account for nearly one-quarter of all workers’ compensation pharmacy costs nationwide. The NCCI also noted that narcotics’ share of workers’ compensation drug costs increases as claims age, that narcotics are used mostly for back injuries in workers’ compensation cases and narcotics use early in the life of claims is increasing.

The PMSI report may point to some “global” changes in workers’ compensation, including more education of physicians on the risks of over-prescribing narcotics to injured workers. Other factors for the reduction may be increased regulatory emphasis on the use of opioids, including mandatory reporting that could result in “more hassle” for doctors – causing them to look to alternative treatment. Another factor may be more “stepped treatment” by doctors, involving use of guidelines which encourage more conservative practices in prescribing. The data may reflect increased use of anti-inflammatory and skeletal muscle relaxants as alternatives to using opioids.

One thing the report makes clear is that pain management is the biggest cost-driver in workers’ compensation. The report notes that despite the decrease in the early use of narcotic analgesics, “the overall use of these medications increased in the course of therapy.” “This pattern confirms that as an injury ages, it no longer responds to first-time medications, thus requiring the need for different agents, including narcotic analgesics to more effectively manage pain.”

To obtain a copy of the report go to http://www.pmsionline.com/annual-drug-trends-report.

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FLU SHOTS – We are already receiving inquiries about flu shots for this fall. OHS-COMPCARE will offer seasonal flu shots to clients again in 2010. To be put on the list to be scheduled for an on-site or to learn more please contact client services at 816-561-2105 (option 1) or by email at customerservice@ohscompcare.com.

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***We are now open Saturdays at our Independence location from 9am – 1pm to serve your occupational medicine and urgent care needs. Our Independence location is open 5pm – 9pm Monday – Friday to serve your after hour needs as well***

*Please feel free to forward this information to any member of management in your company who would benefit from it.*

To view the Tip of the Week in Spanish please visit our Tip of the Week library at http://www.ohscompcare.com/totw/.

To learn more about services OHS-COMPCARE has to offer, contact our Client Services Team at (816) 561-2105 option 1 or by e-mail at customerservice@ohscompcare.com. You can also visit us at www.ohscompcare.com.

Why choose us? Because OHS-COMPCARE has a physician on call 24/7/365 days a year to respond to our client's needs.

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OHS-COMPCARE now featuring Adult Quick Care (Urgent Care Services) has seven (7) area clinical facilities:

Independence Clinical Facility	Johnson County Clinical Facility	St. Joseph Clinical Facility	Grandview Clinical Facility
19000 E. Eastland Center Crt, St. 200	10415 Lackman Road	904 Edmond Street	13830 S Us Highway 71
Independence, MO 64055	Lenexa, KS 66219	St. Joseph, MO 64501	Grandview, MO 64030
816-478-9299	913-495-9905	816-233-7702	816-761-4664
After Hours Available *Now open Saturday 9am – 1pm

KCMO/Broadway Clinical Facility	KCMO/Front Street Clinical Facility	Wyandotte County Clinical Facility
1650 Broadway	6501 East Commerce, Suite 110	1333 Meadowlark Lane, Suite 200
Kansas City, MO 64108	Kansas City, MO 64120	Kansas City, KS 66102
816-842-2020	816-483-5550	913-596-2774

Adult Quick Care provides Urgent Care to Adults and Adolescents Age 14 and Older.

No appointment is necessary at Adult Quick Care.

When you are sick or have a new injury, Adult Quick Care is your affordable, time saving choice for quality care.

To learn more about Adult Quick Care please call 816-559-6320 or visit www.adultquickcare.com.