ENLYTE TRENDS REPORT

Pharmacy Solutions Drug Trends Analysis

The State of Pharmacy Trends in Workers' Compensation

Enlyte provides the most accurate view of continued trends in pharmacy management, by analyzing drug utilization and spending trends in workers’ comp on an annual basis. Our 2023 series reflects on the trends our clients experienced in 2022, providing an overall picture of both in- and out-of-network prescriptions in a four-part series coming throughout the year.

Part 1: Evaluating Retail and Mail Order Prescriptions

As employees head back into the office, we are seeing claim counts beginning to normalize with pharmacy trends following suit. In 2022 our retail and mail order channels continued to see positive results through pharmacy program management.

 

Overall prescription trends saw slight increases in 2022.

Utilization per Cost Cost per Claim Cost per Script

Top 3 Retail and Mail Order Trends

Join Tom Kerr as he interviews Nikki Wilson, Senior Director of Clinical Pharmacy Services to take a deeper dive into part one of our annual drug trends series. In this short video they will discuss standout trends from our most recent retail and mail order data focusing on three observations uncovered within the analysis regarding opioids, migraine medications, and topicals.

Part 2: Evaluating In- and Out-of-Network Trends

Out-of-network prescriptions represent an area of additional opportunity for clinical and cost controls and can often be associated with high-cost drugs. Leveraging both bill review and pharmacy data provides additional visibility into transactions from third-party billers, physician-dispensers, and co-mingled hospital and office visit bills. This analysis features the trends experienced within our combined in- and out-of-network channels to identify a total view of prescription activity.

Key Trend Changes for All Classes

Utilization per Cost Cost per Claim Cost per Script

Out-of-Network Dispensing Channels and Unique Challenges

Join Tom Kerr as he interviews Nikki Wilson, Senior Director of Clinical Pharmacy Services to dive deeper into part two of our annual drug trends series. In this short video they will discuss aggregate trends and challenges within our combined in- and out-of-network channels to address the total view of prescription activity.

Part 3: Evaluating Opioids

Opioids continue to represent a decreasing proportion of overall scripts and costs, with favorable trends seen in important markers such as morphine equivalent dose (MED), duration of use, and access to guideline-supported measures including medication-assisted treatment (MAT) and overdose rescue medication (naloxone).

2022 Aggregate Opioid Trends

Utilization per Cost Cost per Claim Cost per Script

Why Opioid Trends Are Changing in Workers’ Comp

In this Enlyte exclusive podcast, Nikki Wilson, Sr. Director, Clinical Pharmacy Services, takes a deeper dive into the continuing decline of opioid use and the strategies being used to manage them. Wilson focuses on medications driving the activity within the class, why opioids are still considered a high-impact drug class despite their decline, approaches to ensure appropriate opioid utilization moving forward, and how to manage opioid use disorder and minimize their risks. Listen here or click below to read the full conversation.

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Part 4: High Impact Drug Classes

Categories such as topicals, compound kits, combo packs, and specialty medications represent proportionately low workers' comp utilization, however, they can be associated with exponentially significant costs. Recognizing the trends related to such cost drivers can help promote clinically appropriate savings.

2022 Overall Topical Trends

Utilization per Cost Cost per Claim Cost per Script

Why High-Impact Drugs Are Taking a Bigger Piece of Pharm Spend

Part 4 of Enlyte’s Drug Trends Report uncovered significant cost increases in high-impact drug classes, despite relatively low utilization and effectiveness in comp injuries. This includes a topical prescription on the market which has the same active ingredients as OTC products such as a $10 tube of Bengay but with a price tag of $1,500. In this Enlyte-exclusive podcast, Nikki Wilson, Sr. Director, Clinical Pharmacy Services, details why this is happening and how it can be better managed.

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Pharmacy Solutions Webinar

Evaluating an Ever-Changing Pharmacy Landscape in Workers’ Compensation

Payers face numerous challenges in managing pharmacy care in workers’ compensation. Opioids, emerging drug classes, varied dispensing channels, and high-impact pharmaceuticals all require new levels of analysis and understanding. Join us as we wrap up our annual drug trends series and hear our experts share more insights into the latest workers' comp drug trends.

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Miss Out on Last Year's Report?

Check out the 2022 Drug Trends report from Enlyte for one-of-a-kind perspective from experts across the Enlyte family of businesses and see trends and insights from the previous year.

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