The rising costs of pharmaceuticals are leading many to consider ways to reduce unnecessary use of pharmaceuticals. To shed light on key cost drivers, this study, the first in an annual series of prescription benchmarks reports, compares the cost, price, and utilization of prescription drugs in Minnesota with 16 states included in an earlier WCRI prescription benchmarks study.

For those engaged in workers’ compensation public policy debates, this study provides detailed comparisons that may be useful when debating such issues as: pharmacy fee schedules, physician prescribing patterns, medical cost drivers, laws that mandate the use of generics when available, and laws that regulate physician dispensing of prescription drugs at the office. The study will also be useful for those seeking a more in depth understanding of prescription drug costs and utilization across states.

This study makes interstate comparisons at a single point in time. The data are for injuries arising from October 1, 2005, to September 30, 2006, with prescriptions filled through March 31, 2007, and paid for by workers’ compensation payors. The results presented understate the ultimate values of the metrics that depict quantity, since prescription drugs can be used for a long time in a case that continues for multiple years. The next edition of this report will be expanded to 24 months of experience and also examine trends in costs, prices, and utilization of prescription drugs.

The prescription benchmark measures include:

•    Cost Metrics:
  • average payment for prescriptions per claim with prescriptions
•    Price Metrics:
  • average price per pill and average price per prescription
•    Utilization Metrics:
  • average number of pills per claim with prescriptions
  • average number of prescriptions per claim with prescriptions
  • average number of visits to a dispensing point (e.g., pharmacy of physician's office)
  • average number of prescriptions filled per visit
  • average number of pills per prescription

These measures were constructed for all prescriptions, for each of the two dispensing points studied (physician’s office and pharmacy), by therapeutic class, and for specific medications that were commonly used to treat injured workers in each state studied.

 IThe 16 states included in the previous WCRI study are California, Florida, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, New Jersey, New York, North Carolina, Pennsylvania, Tennessee, Texas, and Wisconsin. Individual state reports are available for all states except California, Indiana, Iowa, and New York.

Prescription Benchmarks for Minnesota. Dongchun Wang, Richard A. Victor. October 2010. WC-10-53.

Copyright: WCRI