A Healthesystems publication

Summer 2016


FAST FOCUS: Healthesystems continues to keep watch for developing trends that contribute to pharmacy and overall claims costs. In this issue, we take a look at convenience packs and kits involving topical products, a new copack trend that dramatically increases the price of relatively inexpensive products.

A tube of Voltaren® Gel, a commonly prescribed topical nonsteroidal anti-inflammatory drug (NSAID), typically will cost a payer $60. Yet when it is packaged together with antibacterial wipes, its list price may be about nine times this cost, at $500.

Convenience packs, or “co-packs,” are not a new or original concept in workers’ compensation. A previous popular trend was the combination of a medical food with a generic prescription pain reliever in a convenience pack at a price that was substantially higher than the combined value of the individual components.

However, there has been a significant uptick in these combination packs or kits as they relate to topical analgesics. The packs typically contain two or three products that are readily available individually, either over-the-counter or by prescription. Common combinations are a cream or a lotion paired with an oral agent. In another example, the lotion is paired with antiseptic wipes. In many cases there is a significant and unwarranted cost mark-up on these kits without any real additional value for the patient. With new kits becoming available on the market on a near-weekly basis, this marks a troubling and growing potential driver for claims costs.

Identifying topical packs and kits can be challenging because they can show up in a claim in a variety of ways. They may be categorized based upon a single ingredient or product in the kit, such as a dermatologic, steroid or anti-inflammatory. In other instances, they could fall under a true private-label topical designation.

While packs and kits do not reflect a large percentage of prescription drug transactions, it is among a group of multiple cost drivers that are collectively contributing to overall increases in pharmacy claims costs. These drivers include topics previously reported on by Healthesystems, including private-label topical products, compounds, specialty drugs, and generic price increases.

As new trends emerge and existing ones continue to evolve, there is a need to continually develop new strategies for identifying and mitigating cost drivers in workers’ compensation. Healthesystems will continue to track and report on this growing trend.



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