Pharmacy payments in the oregon workers' compensation system, first quarter 2004

Pharmacy Payments in the Oregon
Workers’ Compensation System,
First Quarter 2004
Department of Consumer & Business Services
The estimated medical payments for treating injured workers during the fi rst calendar quarter of 2004 totaled $66,215,300. This represents a 12 percent increase from the estimated $59,090,500 in total medical payments re-ported during the fi rst calendar quarter of 2002.1 Estimated pharmacy payments totaled $4,106,900 (6.2 percent of total medical payments), up from $3,604,500 (6.1%) in the fi rst quarter of 2002.
Figure 1 breaks down pharmacy payments by drug class (also known as drug category). A drug class contains drugs with similar actions and uses. Narcotic analgesics continue to rank fi rst among the drug classes dispensed to in-jured workers, receiving more than one-third of pharmacy payments. Narcotic analgesic payments are followed by anti-arthritics (also known as anti-infl ammatories) and anti-convulsants (anti-seizure medications), at 16.7 and 11.2 percent of total pharmacy payments, respectively.2 On the following page, Table 1 shows the top pharmacy payments by drug name and pharmacy payments. In 2004, oxycodone HCL, a narcotic analgesic (pain reliever) continued to receive the highest aggregate payment, repre-senting 15.9 percent of pharmacy payments. The top 25 drugs, as a whole, represented nearly 70 percent of phar-macy payments.
Further analysis of workers’ compensation Figure 1. Top drug classes by pharmacy
pharmacy data shows a higher use of generic payments, first quarter 2004
drugs than in general health care. In 2004, generic drugs represented 56 percent of dis- pensed prescriptions in general health care, representing 17 percent of the total dollars spent on dispensed prescriptions.3 In Oregon’s workers’ compensation system, generic drugs scriptions and 26 percent of the total dollars spent on prescriptions in the fi rst quarter of 2004, compared with 62 percent and 26 percent, respectively, in the fi rst quarter of 2002. Additionally, when generic and brand name versions of a drug within the top fi ve drug classes are both available, the generic is dispensed more than 90 percent of the time. Because the top fi ve drug classes contribute over four-fi fths of the total dollars, the work- ers’ compensation system has experienced signifi cant cost savings as a result of generic Note: Percents may not total 100 due to rounding.
2 It is common for anti-convulsants, most often Neurontin, to be prescribed for purposes other than seizure suppression; typically for “off-label” use in relieving neuropathic and neurogenic pain and in migraine prophylaxis. The FDA approves a drug for a specifi c, labeled purpose, but some drug references, such as the Physicians’ Desktop Reference, provide alternative, “off-label” purposes.
3 See IMS Health, a pharmaceutical information and consulting company, National Prescription Audit Plus™ and National Sales Perspectives™, Table 1. Top 25 drug names by pharmacy payment
Generic or
Drug name
Drug class
Product name
brand drug
payments
payments
$654,600
$354,500
$231,100
Norco, Lortab, Vicodin (ES and HP), Lorcet $200,300
$181,600
$141,100
$104,300
Subtotal
$2,829,900
Remaining pharmacy payments
$1,277,000
$4,106,900
Note: Drug payment fi gures are rounded to the nearest hundred; fi gures and percents may not add to totals due to rounding.
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Source: http://www.osia.com/2013Annual-WC_Pharm_Pmts_OR2004.pdf