Report Details Drug Dispensing in California Workers’ Comp

October 3, 2016

California’s Workers’ Compensation Insurance Rating Bureau has issued a report that shows the share of drug payments made directly to dispensing physicians compared with pharmacies fell by 20 percent over three years.

The report, “Patterns of Drug Dispensing in California Workers Compensation,” analyzed $500 million in workers’ comp pharmaceutical payments from July 2012 through December 2015.

WCIRB researchers say they used reported medical payment data representing more than 90 percent of the California workers’ comp insurance market.

Among the findings of the report are:

The share of drug payments made directly to dispensing physicians compared to pharmacies declined by 20 percent from July 2012 through December 2015.

This change in dispensing patterns occurred across all types of drugs, and was especially apparent for opiate analgesics and base ingredients used in compounds.

These trends were driven by a drop in the number of prescriptions per claim rather than a change in unit payments.

Physicians received higher unit payments for specific types of opiate analgesics and stomach discomfort drugs when compared to equivalent medications available at pharmacies.

The Los Angeles basin area generated 86 percent of all payments for compound drugs as compared to only 60 percent of other non-compound drug payments.

The reduction in physician dispensing may help, in part, explain the overall 28 percent drop in drug spending per claim from the second half 2012 through the second half 2015 documented by prior WCIRB research.

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