I'm part way through the Seventh Annual Survey of Prescription Drug Management in Workers Comp, and have a couple of initial impressions worth sharing.

First, and no surprise, is the increased concern about the growth of narcotic opioid usage in comp. Every respondent save one has specifically mentioned opioid usage as a significant problem, contributor to drug costs, and/or area of focus. Many have, or are about to, implement programs designed specifically to address narcotic opioids, with some taking rather aggressive positions to attack off-label usage.

Second, respondents are more concerned about drug costs this year than last, and believe executives in their companies are also tracking drug costs with more interest.

Third, more and more payers are using more and more sophisticated programs to deal with drug utilization - involving pharmacists in the prior authorization process, providing access to physicians for review of selected high cost cases, getting tighter and more restrictive formularies, and implementing step therapy programs.

Fourth, most respondents believe compound medications are a very significant problem; several have developed or are working on programs to address compound meds.

Details on these and other findings will be provided in the final report; as always respondents get a detailed copy of the report; there will also be a summary report available to the public.

If you are interested in participating in the survey (insurers, TPAs, self-insured employers, and managed care firms), send an email to infoAThealthstrategyassocDOTcom.

And thanks to those folks who've agreed to participate this year - your insights and understanding will help all of us get better at managing drug costs.

You can download copies of past reports here.