Workers' Comp

Ask The Pharmacist: The Role of a Pharmacy and Therapeutics (P&T) Committee

March 1, 2024

Jonathan Rowell, Pharm. D.

Clinical Pharmacist, Pharmacy Solutions

Cameron Hannum, Pharm.D.

Sr. Clinical Account Pharmacist

How does a P&T committee influence a workers’ compensation pharmacy program?

A Pharmacy and Therapeutics (P&T) committee plays a crucial role in the realm of health care, particularly in the context of a workers’ compensation pharmacy benefit manager (PBM). This committee is comprised of health care professionals, such as physicians and pharmacists, who are responsible for evaluating and making decisions about the formulary—a continually updated list of medications covered by a prescription drug plan.

In the context of a workers’ compensation PBM, a P&T committee focuses on optimizing medication utilization for injured employees. Their primary role is to assess the safety, efficacy, and cost-effectiveness of medications within a formulary to make sure they are clinically appropriate. This involves reviewing clinical guidelines (including the Official Disability Guidelines or American College of Occupational and Environmental Medicine), state workers’ compensation formularies (such as in California and New York), and staying abreast of medications that are new to the marketplace.

Enlyte’s panel meets on a quarterly basis to discuss medication-use policies that may affect the workers’ compensation industry. The committee works to find a consensus on providing effective treatment options and controlling costs. This may include discussing where medications may be placed on our standard workers’ compensation formulary.

P&T committee decisions can significantly impact the health and well-being of injured employees. By carefully evaluating medications, considering their cost-effectiveness, and adapting to medical advancements, the committee contributes to a balance between quality care and cost containment. 

Overall, a P&T committee serves as a critical decision-making body, guiding the selection and management of medications within the workers’ compensation PBM framework. Their efforts ensure that injured employees receive appropriate and effective treatments while maintaining fiscal responsibility and sustainability within the workers’ compensation system.

This information is meant to serve as a general overview, and any specific questions should be more fully reviewed with your health care professional such as the prescribing doctor or dispensing pharmacist.

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