FDA Approves First Lyrica Generics

In late July, the FDA approved the first generic versions of Lyrica (pregabalin), granting approvals to a total of nine pharmaceutical companies for five different conditions. Lyrica is seen in many workers’ comp claims for the treatment of neuropathic pain, and these generic approvals could result in greater utilization across claims with reduced costs.

This approval covers the following indications:

  • The management of neuropathic pain associated with spinal cord injury
  • Neuropathic pain associated with diabetic peripheral neuropathy
  • The management of postherpetic neuralgia (shingles pain)
  • Use as an adjunctive therapy for the treatment of partial onset seizures
  • The management of fibromyalgia

The most common side effects reported in the clinical trials for Lyrica in adults are dizziness, somnolence, dry mouth, swelling, blurred vision, weight gain and abnormal thinking (primarily difficulty with concentration/attention). Pregabalin may cause dizziness and drowsiness and impair ability to drive or operate machinery.

According to the FDA, pregabalin warnings include the risk of angioedema (swelling of the throat, head and neck), which may be associated with life-threatening respiratory compromise requiring emergency treatment. Increased seizure frequency or other adverse reactions may occur if the drug is rapidly discontinued. Antiepileptic drugs, including pregabalin, increase the risk of suicidal thoughts or behavior.

For further information, read the FDA News Release.

Tags: Lyrica, pregabalin, generic, FDA, drug approval, product approval

Healthesystems AVP of Advocacy & Compliance Named Finalist for Comp Laude Award

Healthesystems is proud to announce that our AVP of Advocacy & Compliance, Sandy Shtab, was named a finalist for the 2019 Comp Laude Awards, an annual continuing education and networking event that takes time to honor esteemed individuals who have made significant contributions to the workers’ comp industry.

WorkCompCentral, a news publication and educational organization that provides access to information and collaboration opportunities for workers’ comp professionals, has hosted the Comp Laude Awards & Gala since 2012, and Healthesystems is thrilled to see Sandy recognized for her outstanding work.

Sandy has accomplished much in her time with Healthesystems, working heavily behind the scenes to ensure that our programs and solutions comply with state and federal regulations surrounding EDI, payment and billing, treatment guidelines, formularies, fee schedules, and much more. Sandy regularly delivers her expertise on legislative trends that will impact the industry, keeping our clients looking forward on new and evolving issues, while also composing testimony and written commentary to deliver during public rulemaking procedures that have significant impact for our clients and industry.

The Comp Laude Awards & Gala will take place September 23-25 in Huntington Beach, California.

Tags: Comp Laude, Sandy, Shtab, award, Healthesystems

FAIR Health Publishes Telemedicine Report

FAIR Health, a non-profit organization that collects data on healthcare costs and coverage, recently published a white paper examining how telehealth is impacting the healthcare landscape.

This report drew upon a repository of over 29 billion private healthcare claim records, the largest in the nation, and found that telehealth grew 53% from 2016-2017, and another 26% from 2017-2018. Overall, from 2014-2018, claim lines related to any type of telehealth have increased 624%. Furthermore, telehealth grew 1,289% in urban areas from 2012-2017, compared to rural areas, which experienced 482% growth in the same time period.

However, different types of telehealth saw different levels of growth when taking into account geography, age, gender, and diagnoses.

The study divides telehealth into four types, measuring their utilization from 2014-2018:

  • Provider-to-patient-non-hospital-based-telehealth, where the provider and patient communicate via telehealth without relation to a hospital. This form of telehealth grew 14-fold, and more in urban areas than rural areas. By 2018, this branch made up 84% of all telehealth services
  • Provider-to-patient-discharge telehealth, where the telehealth visit is a follow-up after the patient is discharged from a hospital. This form of telehealth more than doubled, with 82% of these claims for individuals aged 51 and older
  • Provider-to-provider, which involves consultation between healthcare professionals. This form of telehealth more than doubled, but by 2018 only made up 3% of telehealth services
  • Physician-to-patient-ED/inpatient telehealth, where the patient is in the hospital, either in the emergency department or as an inpatient, communicating via telehealth with a physician. This form of telehealth grew four-fold, but consistently made up less than 1% of telehealth services

Other final observations of the study were:

  • Telehealth services were well distributed by age
  • 65% of all telehealth claim lines from 2014-2018 were associated with females, although when broken down to discharge-related telehealth, women made up 53% of those telehealth claims
  • Acute upper respiratory infections were the number one reason individuals sought telehealth treatment in 2018, making up just over 15% of telehealth claim lines

Tags: telehealth, FAIR Health, discharge, provider, inpatient, age, rural, urban

WCRI Reports on Interstate Variation in Dispensing Opioids

The Workers’ Compensation Research Institute (WCRI) recently published Interstate Variations in Dispensing of Opioids, 5th Edition, a study that examines the prevalence and trends in the dispensing of opioids in 27 states.

This report looks at 575,000 nonsurgical claims with more than seven days of lost time from injuries between October 1, 2011 and September 30, 2016, with medical treatments received through March 31, 2018, capturing an average of 24 months of experience. This sample includes over 4.3 million prescriptions and represents 37-72% of workers’ comp claims in each state.

According to the findings, opioid prescribing dropped significantly in the 27 study states, ranging from an 8% drop in Illinois to a 25% drop in California. At over 160 pages, this report features various insights into the many study states included. The following are highlights of the report:

  • In California, 38% of claims with prescriptions received opioids from 2016-2018, a significant drop from 62% from 2012-2014
  • Prescriptions dropped 20-22% in Connecticut, Delaware, Nevada, and New York, while prescriptions dropped 15-19% in Florida, Georgia, Indiana, Kentucky, Massachusetts, Minnesota, and New Jersey
  • Average morphine milligram equivalence (MME) per worker in the first two years of a claim decreased in nearly all states; 17 states saw reductions of 30% or more, while Iowa, Maryland, New York, North Carolina, South Carolina, Tennessee and Wisconsin experienced 42-48% drops in MME. But beating them out, California, Connecticut, and Kentucky experienced MME reductions of 50% or higher
  • Delaware, Louisiana, Pennsylvania, and New York saw the highest average MME per worker. Delaware and Louisiana saw MME per claim go beyond 3,200 milligrams, more than three times the 27-state median
  • Opioid dispensing was still prevalent in several states, with the percentage of injured workers’ receiving opioids ranging from 32% in New Jersey and 70% in Arkansas and Louisiana
  • While fewer injured workers receive opioids, there has been no proportional increase in the percent of workers receiving non-opioid pain medications

For further insights, download the report from WCRI.

Tags: WCRI, opioid, opioid dispensing, opioid prescribing, MME

Will Autonomous Vehicles Impact Workers’ Comp?

The National Council on Compensation Insurance (NCCI) recently published “Braking” New Ground: Autonomous Vehicles & Workers’ Compensation, exploring how self-driving cars could impact workers’ comp in the near future.

Citing data from the Bureau of Labor Statistics, 30% of civilian jobs required some driving in 2016, and it is hypothesized that autonomous vehicles could partially or completely replace some of these job functions. While this would imply significant economic impacts, for workers’ comp this has the potential to greatly reduce motor vehicle accidents (MVAs).

The National Highway Traffic Safety Administration (NHTSA) found that the number of road fatalities in the United States increased by over 14% from 2014-2016. Furthermore, NCCI data found that MVA claim frequency has increased in workers’ comp in recent years, a trend sometimes attributed to increased smartphone penetration in the market, creating more distracted drivers, applying to both employees and other drivers on the road.

According to NCCI, over the last five years, more than 40% of workers’ comp fatalities involved MVAs, and MVA claims cost 80-100% more than the average claim because they involve more severe injuries. Furthermore, driving-related classifications account for 25% of workers’ comp payroll and 50% of workers’ comp premiums.

It is estimated that a 25-75% reduction in MVA claims could yield savings between $1 billion to $4 billion, indicating that significant evolution of self-driving technology, if it effectively reduced MVAs, could lead to great savings in workers’ comp spend.

Though the technology still has room to grow, and while there are various other considerations to keep in mind, self-driving vehicles could very soon prove worthwhile to workers’ comp, as other safety advancements have led to increases in safety.

According to the Insurance Institute for Highway Safety, a forward collision warning system coupled with autobrake can reduce front-to-rear crashes with injuries by 56%. However, a caveat to findings such as these is that drivers may grow overly reliant on expanded safety features. One study found that when drivers had an automated parallel parking system, they were less aware of their surroundings than drivers who did not have such functionality.

Tags: NCCI, self-driving cars, autonomous vehicle, motor vehicle accident