A new report issued by Express Scrips and profiled in WorkersCompensation.com shows that Wilfredo Pareto was onto something. The report looks at what the writers call the “super spenders” in prescription drug costs, folks who spend $50K or more annually on maintenance pharmaceuticals, generally for chronic conditions. In 2016, about 3 out of every 1,000 people in the analysis accounted for more than 20 percent of total pharmacy spending.
Glen Stettin, M.D., Senior Vice President, Clinical, Research and New Solutions at Express Scripts observed, “At a fraction of a percent of all Americans, this population may seem small. However, every person in America is on a first-name basis with at least one other person – a relative, friend, or colleague – who has annual drug costs that are nearly the same amount as the median U.S. household income.” (According to the US Census Bureau, that’s $57,617 as of earlier this year.)
As a risk manager, you probably know a few of these folks also. Some of them are your fellow employees, while others visit your company premises for various reasons or drive in the same traffic as your company vehicles. And that’s the rub. When a person taking one or more complex drugs, or a whole cocktail of sophisticated medicines, is involved in a workers’ compensation incident or a premises or auto liability claim, the clinical component and management of that claim goes to a whole new level.
Consider – potential drug interactions can go off the charts. Common co-morbid issues ratchet up. The involvement of medicines commonly used in the treatment of musculoskeletal injuries – like opioids and relaxants – can become highly problematic. Reviewing potential drug interactions takes on new urgency. As the number of ordinary, working citizens on complex drug regimens continues to go up, the importance of getting a full drug and co-morbid history and having a first class drug interaction review process built into your claims handling also goes up. This applies to far more than just your comp claims. Think about a slip and fall in a company restroom or a fender bender on the interstate. All types of physical injury become potential bottomless pits when the injured party was already on a $50K annual drug regimen.
The mantra of the 21st Century seems to be “nothing ever gets simpler.” Pre-existing conditions used to be an issue for the benefits manager across the hall. Now it’s in your inbox as well.
The GB Journal is Gallagher Bassett’s semi-monthly quick reviews of new studies and related insights affecting risk management and self-insurance. For more information, please connect with GB on LinkedIn, follow us on Twitter, or contact the author, Dr. Gary Anderberg, directly. Reproduced with permission.