myMatrixx Delivers 6.1% Decrease in Workers’ Compensation Prescription Drug Spend

Payers with a workers’ compensation program managed by myMatrixx experienced a 6.1 percent decline in total costs. (Estimated reading time: ~3 mins.)
myMatrixx Drug Trend Report

Today, myMatrixx released our 14th annual Drug Trend Report, which shows workers’ compensation pharmacy spending for customers managed by myMatrixx decreased by 6.1 percent in 2019.  

Through our customized workers compensation programs that focus on patient safety and clinical care, we’re helping our clients balance appropriate care for injured workers while keeping costs down. And, we’re able to do this at all phases during the life of a workers’ compensation claim through monitoring and clinical intervention.

Without a doubt, our country and the world are facing unprecedented times. As we support our customers and partners during the COVID-19 pandemic, we’re remaining laser-focused on managing injured workers’ prescription drug needs. Let’s examine what we’re learning from 2019 data as well as take a look at emerging drug trends.

In 2019, payers with a workers’ compensation program managed by myMatrixx experienced a 6.1 percent decline in total costs and a 4.3 percent decrease in the number of prescriptions. At the injured patient level, prescription drug costs decreased 2.4 percent even though utilization increased 1.9 percent, which highlights the impact of the trend we have identified as the Age of Claim effect.

Improving Spend and Safety of Opioid Use

By leveraging data to create proactive points of intervention, educating injured workers and ensuring connectivity across the care continuum, myMatrixx has continued to implement strategies to protect injured workers from the misuse and abuse of opioids. Average spending on opioids declined by 10.7 percent for payers between 2018 and 2019. In fact, overall payer spend on opioids between 2015 and 2019 declined 45.1 percent. In addition, injured workers are taking opioids for shorter periods of time. In 2019, 14.7 percent of injured workers used opioids for 30 or more days, down from 17.0 percent in 2018.

Generic Substitution Yields Savings

Generic substitution remained a cornerstone of myMatrixx’s strategy to offset the cost of name brand prescriptions which saw list price inflation of 70.5 percent from 2014-2019. A primary driver of generic savings was the launch of pregabalin, the generic version of Lyrica®, used to treat neuropathic pain. Aggressive substitution strategies assured that payers received maximum benefit as soon as possible.

Other Key Findings

  • An increase in the use of private-label topicals. These products are marketed to and distributed only by prescribers, but they are driving significant costs, often with little to no therapeutic advantage over traditional topical products available through our retail pharmacy network.
  • Specialty therapy costs in workers’ compensation continued to increase in 2019, with an 18 percent increase in spend and a 27.0 percent increase in utilization. Note that the biggest impact from generic substitution in coming years may be within this market.
  • With an increase in the median workforce age, 40.4 percent of injured workers were age 55+ in 2019. myMatrixx has identified this trend as the Age of Patient effect and consults with prescribers frequently regarding drug therapy management for senior patients.

Market conditions as well as a public health concerns continue to change, but our mission on behalf of America’s injured workers has never been more important. Through innovative data analytics and focused clinical expertise, we’re putting injured workers on a safer path to treatment and helping to make health care more simple and affordable.

For additional data and workers compensation trend insights, download the full report here.


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