PBM: Out-of-Network Compound Prescriptions Often Escape Detection

A step as simple as requiring pharmacies to denote a compounded medication with a “C” on billing statements could help rein in spending and overuse of compounded drugs in workers’ compensation, according to officials with a cost-containment company. Otherwise, when the bill hits a claims adjuster’s desk, the adjuster might not even recognize that the prescription is for a compounded drug, a treatment that may be subject to additional scrutiny or a preauthorization requirement. That is one of the challenges in controlling the use of compounded medications in worke...