Workers' Comp

Enlyte Pharmacists Discuss a Changing Workers’ Comp Pharmacy Landscape

June 24, 2024

Nikki Wilson, Pharm.D./MBA

Senior Director of Clinical Pharmacy Services

Dr. Mitch Freeman, Pharm.D.

Chief Clinical Officer

Workers' compensation pharmacy is constantly evolving, from tackling the opioid crisis, to the rise of compounding pharmacies, to the pandemic. Amidst these changes, pharmacy benefit managers must constantly evolve to address an array of industry changes. In our final Enlytening Conversation our pharmacists discuss how changes within the industry as a whole including physician shortages, digital therapeutics, biopsychosocial approaches, new drug treatments, and much more are driving the need for constant planning and innovation to stay a step ahead in this ever-changing landscape.


Mitch Freeman (MF): When you look back at workers' compensation pharmacy, it's gone through a lot of changes. So, you know, I remember when the opioid crisis came up and it, you know, it impacted workers' compensation, disproportionately to the, you know, the rest of the country. You know, there were changes as well, compounding pharmacy came in. And it's not much of an issue now because for the most part, you know, those problems have been solved. You get into physician dispensing, out-of-network pharmacy, I think the only thing consistent in workers' compensation pharmacy is that it changes. Right. So what do you think what's next?

Nikki Wilson (NW): I think that's definitely a big deal. It's looking at the past learning from what the challenges have been, but like you said, there's always a next thing. There's always new stuff evolving. It's changing. So having a really good plan for how are you gonna innovate? How are you gonna stay ahead of some of those challenges? Anticipate some of those challenges. So looking at market trends and really having a finger on the pulse of what's going on, not just at the industry level, so not just what's impacting comp, but just bigger picture.

NW: The way that we drive product development, I think this is the way to do it, is to look very macro level. So what are the changes impacting? Let's say, for example health care. We have physician shortages. We have the impact of the pandemic where nurses are burned out, and all of our health care workers are struggling these days with, overwhelmed care, and it's getting better every day, but that's certainly the environment. We're also starting to see an expansion of things like telehealth. The pandemic also drove a lot of that where all of a sudden no one was able to leave their homes. And those things transformed care forever. Where now we have more opportunities to treat differently. Different treatment opportunities. Digital therapeutics is a big new space with everyone having a smartphone in their hands. How can we deliver care right to the user through an app?

NW: Or some sort of health technology. So looking at those kinds of health care changes, focus on biopsychosocial approach to health care, that's certainly been an impact at the macro level that we're seeing a shift in health care in general. So keeping those things in mind and then drilling them down into how we use them within our own programs internally to impact the comp space is so important.

NW: Not only that, but in comp, we have a number of workplace changes that I think are impacting and causing issues and challenges for a lot of our industry, and those are things like we have an aging workforce. They're five different generations at work right now, and what the drug mix might look like for a person over sixty-five who might still be on the job and all of the different things that they're taking and having to manage that through pharmacy is likely very different than a young twenty-four year old just getting their start in the industry. So those types of things, other challenges in the workplace, all of the work from home, the mix in a remote versus on-site, so when a workplace injury happens, it could be at your desk in your home office.

NW: So how do those coverage options impact our care? So that's all very macro level. But what we try to do is think about what those trends are that are coming, watch the market trends, start to innovate around them, anticipate needs that might come out of those. Investigational therapies is another big one, watching everything that's happening in the space with psychedelics. You and I were just talking about this. Some of the new investigational drug treatments for things like PTSD and depression.

NW: So understanding how those might impact our space starting to think ahead for how we can support management of those challenging pharmaceuticals and payments. Mental health, that's a big focus right now. So we're seeing definitely lots of changes within the industry and being able to innovate around those. Plan what clients may need, what pharmacy might need as a result of some of those big challenges is so important. And so we're doing a lot of things in our space to try to think ahead and develop programs to manage those things.