In July of 2012 we took a look at
the early results of the prescription drug formulary in Ohio
and in Texas. Both were showing signs of
favorable results.
Where do we sit 18 months later? In a word, progress.
The Ohio Bureau of Workers Compensation has recently reported a reduction in
prescription drug costs by $22.2 million (16%) since the formulary went into
effect. Included in that curtailment is an 18.1% reduction in narcotic
prescriptions and a 36.4 % reduction in skeletal muscle relaxants for the first
half of 2013 as compared to the first half of 2012. (BWC Annual Report)
Texas has seen even greater
results between its two categories of claims.
For injured workers’ with dates of injury after September 2011, prescription
rates of drugs not recommended by the Texas closed formulary dropped 56% - a
number matched by a cost reduction of over 81%.
Legacy Claims posted similar results with a 23 % reduction in prescriptions
and a 21% reduction in cost. (TDI, Workers’ Compensation Research and
Evaluation Group, 2013.)
While the closed formularies are clearly
having a meaningful impact on prescription drug costs in these states, the
approaches differ quite drastically.
Ohio, a monopolistic work comp state, has implemented a closed formulary
that it developed on its own. Texas is
relying on its well established utilization review process and a third party
set of guidelines (ODG’s N drugs) for its implementation of a closed
formulary. Take-away: there are
different ways of implementing the concept that have been proven to work.
Closed formularies aren’t
implemented over night. If other states
want to start making meaningful impacts to their prescription drug costs at any
point in the near future, decision makers had better have some big plans for
their upcoming legislative sessions.
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