Monday, October 9, 2017

Exorbitant Price Increases in Workers’ Compensation



Sudden and exorbitant drug price increases in recent years have brought the annual cost of treatment for some patients to hundreds of thousands of dollars, and have forced others to go without, sparking outrage throughout the United States.

Price increases involving critical, life-saving drugs like EpiPen® and Daraprim® have been labeled “outrageous”, “predatory”, and “price gouging” events that solely drive drug company profits. The example of Daraprim®, a medication that had been available for 63 years yet had a 5,000% price increase in a single day, was so shocking it sparked a U.S. Senate special investigation and report. While drug price spikes involving prescriptions used in the group health setting have been widely covered in the press, unfortunately, the same pricing trend has occurred with several drugs used in the pain management setting for Workers’ Compensation injuries. The following chart contains three such examples:

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Vimovo®: This brand-name combination NSAID/PPI was historically manufactured by AstraZeneca for approximately $2/capsule. However, in January 2014 the rights to manufacture Vimovo® were sold to Horizon Pharma, which increased the cost, overnight, to $16/capsule (a 700% price increase). Horizon has since increased the cost of Vimovo® on a regular basis with a current, exorbitant price of $2,710.90 ($45.18/capsule).

Pennsaid®: The price of this is topically applied NSAID was increased by 480% in one day in January 2015 by Horizon Pharma. Since that time the cost has risen even further to an excessive $2,716.02 per prescription.

Levorphanol: This “generic” opioid has only one manufacturer, Sentynl Therapeutics. Given they are the sole generic manufacturer of levorphanol, they have increased the cost by an astronomical 2,959% since 2011, currently charging nearly $50 per tablet.

If, in this financially turbulent pharmaceutical environment, you find patients on inordinately high-priced mediations such as Vimovo®, Pennsaid®, or levorphanol, often the prescriber is not aware of the exorbitant cost of these products and/or the safe, effective treatment options available. While primary consideration should always be clinical efficacy, having an open, transparent discussion with the prescribing provider about these unfortunate realities can only be of benefit to all parties with a vested interest in the outcome of care.

About the Author: Anthony Sambucini is a founding principal and the Chief Executive Officer of ANS Solutions. Anthony specializes in bridging the goals of  and business strategy that have helped propel ANS Solutions into a national leader in Pharmacotherapy Review Services for workers’ comp insurers and ANS Pharmacotherapy Review Program is the most advanced, results-oriented drug utilization review program in the industry. As a consultant to insurance carriers and attorneys, Anthony customizes services based on the particular needs of the client and oversees all activities related to business development and company operations. For more information about ANS Solutions visit http://ans-solutions.com/.

Original content posted on http://ans-solutions.com/exorbitant-price-increases-workers-compensation/