Texas: Comp drug payments significantly higher than states in study

The cost per claim for prescription drugs used to treat injured workers in Texas was nearly 30 percent higher than in other states in a recent study.

A 16-state study by the Workers Compensation Research Institute found that the average payment per claim for prescription drugs in the Texas workers' compensation system was $536 -- nearly one-third higher than the median of the study states. Researchers said the main reason for the higher prescription costs was the higher utilization of prescription drugs. The average number of pills per claim in Texas was 41 percent higher than the 16-state median. At the same time, the study noted that the average number of prescriptions per workers' comp claim was 34 percent higher.

Researchers found that while injured Texas workers received the same types of medications as employees did in the other states, physicians prescribed more frequently for muscle relaxants and anti-infectives. For example, Carisoprodol, a muscle relaxant, was received by 8 percent of the injured workers in Texas. This is in contrast with 2 to 4 percent of claims in most other states, except in a few states where physician dispensing was a significant cost driver. Researchers said this may be due to regional differences in the training of physicians or practice norms.

Use of Schedule II narcotics decreases among California injured workers (08/13/12)
IAIABC, ACOEM target state workers' comp agencies with opioid message (10/24/11)
Study shows increasing frequency, costs of physician-dispensed meds (09/06/12)
Opioids, physician dispensing continue to concern practitioners (02/25/13)
Opioids, physician dispensing are major concerns among WC payers (02/11/13)

The study noted that the average price per pill paid to pharmacies in Texas was similar to the median of the 16 study states. However, physicians in Texas use brand name medications for 20 percent of all prescriptions compared with 15 percent in the median state. Researchers said this occurred when generic equivalents were available, and more often, when generic equivalents were not available, but generic alternatives were available.

Unlike many states studied, WCRI found that physicians in Texas were generally not permitted to dispense prescription drugs.

Read more at the WorkersComp Forum homepage.

September 2, 2010

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