Retail and Mail Order Prescriptions
3 MIN READ
Overall cost and utilization by claim were down in 2025 even with 6 of the top 10 therapeutic classes experiencing rising cost per script. Migraine medications rose by nearly 10%, representing the largest script cost gains driven in part by increases in brand Average Wholesale Price (AWP) including brand AWP for migraine medications increasing 2.4%. Utilization per claim also jumped in the migraine medication class (up 9.6%), while every other class within the top 10 (besides topicals, which rose 2.5%) experienced decreased utilization.
Ask The Pharmacist: What Work Comp Adjusters Should Know About New Generic Tapentadol
4 MIN READ
Generic versions of Nucynta are now available in the U.S. market. For workers’ compensation claims, this may create brand-to-generic conversion opportunities, especially as part of a longer-term pain regimen.
A 16,000% Problem: Why Workers’ Comp Can’t Get Drug Costs Under Control
Workers’ comp pharmacy costs continue to rise due to limited network control. Learn how structural gaps drive pricing abuse and what states can do to fix it.
Five Pain Management Trends Workers’ Compensation Leaders Should Watch
2 MIN READ
Workers’ compensation pain management trends are shifting as non-opioid therapies, topicals and high-cost drugs reshape pharmacy program oversight. See five trends that can help claims leaders evaluate cost, utilization and clinical strategy.
Ask The Pharmacist: Medication Step Therapy in Workers’ Compensation
3 MIN READ
When you review a medication request, it’s not always clear why one drug is approved first and another is not. That is where step therapy comes in. In workers’ compensation, step therapy gives you a structured, evidence-based framework for evaluating medication requests, starting with well-supported, lower-risk treatments before moving to other options when medically necessary.
Less Leakage, More Leverage: Reconnecting the P&C Cost Chain
4 MIN READ
Executive VP Dave Torrence explores how fragmented systems drive cost leakage in P&C claims, and how integrating clinical oversight, pharmacy management, payment integrity and network strategy can improve visibility, strengthen decisions and improve outcomes while reducing total claim spend.
Business Insurance Video: Comp Spotlight with Michele Hibbert
See Michele Hibbert break down the impact of new state legislation on AI-powered claims processes in this exclusive Business Insurance "Comp Spotlight" interview.
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