WCRI Study Finds Payment Per Claim For Drugs Prescribed To IL Injured Workers Was Lower Than Median

The 16-state study by the Cambridge, MA-based WCRI found that the average payment per claim for prescription drugs in the Illinois workers' compensation system was $361, slightly lower than the median of the study states.

The average price per pill paid to pharmacies in Illinois was close to the median of the 16 states. Typical prices were seen for medications that were most commonly used in treating injured workers in Illinois.

The WCRI study, Prescription Benchmarks for Illinois, found that although the average price per pill paid to pharmacies in Illinois was close to the median of the 16 states, the price was higher in Illinois compared to what was paid in nearby states (Indiana, Iowa, Michigan, and Wisconsin).

The study also noted that the utilization of prescription drugs in Illinois was similar to the median state, reflected in the average number of pills per claim and the average number of prescriptions per claim with prescription. Typical utilization was seen for the medications that were commonly used to treat injured workers in Illinois.     

Prescription costs per claim in Illinois might be lower but for higher priced physician dispensing, WCRI reported.

Some Illinois physicians wrote and dispensed prescriptions at their offices directly to the patient. Physicians dispensed 22 percent of all prescriptions. When physicians dispensed prescription drugs, they were paid higher than what pharmacies would have been paid for the same prescription. For example, the average price per pill paid for the painkiller Vicodin® was $0.78 if the prescription was dispensed in a physician's office, but $0.53 when filled at a pharmacy.

The Workers Compensation Research Institute is a nonpartisan, not-for-profit membership organization conducting public policy research on workers' compensation, healthcare and disability issues.  Its members include employers, insurers, insurance regulators and state administrative agencies in the U.S., Canada, Australia and New Zealand as well as several state labor organizations.

Source:  Workers Compensation Research Institute

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