WCRI study finds cost per claim for prescription drugs to treat injured workers in Maryland higher

The cost per claim for prescription drugs used to treat injured workers in Maryland was slightly higher than in most study states in a new study by the Workers Compensation Research Institute (WCRI).

The 16-state study by the Cambridge, MA-based WCRI found that the average payment per claim for prescription drugs in the Maryland workers' compensation system was $441—7 percent higher than the median of the study states.

Prices paid to pharmacies in Maryland were similar to those in the median state, as was utilization of prescription drugs, measured by the average number of pills per claim and the average number of prescriptions per claim with prescriptions. Prescription costs per claim in Maryland might have been lower, but for higher priced physician dispensing, according to WCRI.

The WCRI study, Prescription Benchmarks for Maryland, found that some Maryland physicians dispensed prescription drugs directly to the patient at their offices. This occurred in 47 percent of claims with prescriptions and accounted for 24 percent of all prescriptions paid under workers' compensation.

Maryland physicians who dispensed prescriptions were paid higher prices than if the same prescription was filled at a pharmacy. Among the most commonly used prescription drugs, the largest price differential was for Carisoprodol (Soma^®), a muscle relaxant. The average price per pill paid for this drug was $2.59 when the prescription was filled at a physician's office, nearly 4 times what would be paid if the same prescription was filled at a pharmacy ($0.67). On average, physician-dispensers were often paid about 20-70 percent higher than pharmacies for the same drugs.

Financial incentives may help explain a higher utilization of the drugs that had a higher price differential. For example, 8 percent of the workers in Maryland received Carisoprodol compared to 4 percent in the median state. The average Maryland worker received 3.5 prescriptions for Carisoprodol and 161 pills per claim, compared to 2.7 prescription and 124 pills per claim for the same drug in the median state.

The WCRI study is the first in an annual series that benchmarks the cost, price and utilization of pharmaceuticals in workers' compensation.

SOURCE Workers Compensation Research Institute