Emerging trends in pharmaceutical design and drug manufacturing are shifting toward presenting the market with new ways to develop medications. Specialty medications continue to be a major area of pharmaceutical development and have become widely discussed in workers’ comp due to their significant costs. Although they represent approximately 1% of drug utilization, they account for nearly 7% of prescription drug costs and represent the fastest-growing segment of the U.S. pharmaceutical market. While specialty drug products are often associated with a hefty price tag, some can offer clinical advantages when deployed for the right patient at the right time, making careful oversight and patient selection imperative to achieving desired outcomes in this space. Watch the video blog to learn more.
More stories
Workers’ Compensation Medical Claims
Medical severity — not overall claim frequency — emerges as the defining trend across the 2022–2025 loss years. Enlyte data is consistent with NCCI and WCRI reporting, overall workers’ compensation claim frequency remains flat to declining nationally. The notable change within this dataset is not the number of claims occurring across the system, but rather how medical services are being delivered, accessed, and utilized within existing claims.
Macro Signals: Workers’ Compensation and Personal Auto
Workers’ compensation continues to be one of the P&C industry’s most consistent underwriting success stories, supported by sustained operational discipline rather than short‑term tailwinds.
Macro Signals: State of the P&C Industry
Claims management does not operate in isolation. It responds to — and reflects — broader economic, legal and structural forces shaping the insurance market. Pricing cycles, inflationary pressures, labor dynamics, medical cost trends, litigation patterns and capital market performance all converge to influence loss ratios and operational strategy.
Complex Claims Need More Than a UR Determination
Complex claims require more than a utilization review determination. Learn how connecting UR with case management, pharmacy, peer review and clinical oversight helps claims teams identify risks, remove barriers and improve outcomes.
Why Bodily Injury Claims are Being Overpaid and How to Stop It
Join Enlyte for a 30-minute discussion on why even strong claims teams are seeing leakage in bodily injury claims and why it often comes down to inconsistent demand evaluation creating unnecessary financial exposure.
The Next Generation of Claim Handlers Is Forcing a Rethink of How Referral Management Gets Done
As experienced claim handlers retire, a new generation is reshaping referral management. Discover how automation and connected workflows reduce administrative burden and support faster claim outcomes.