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Paduda: Compounds in Workers' Comp

By Joe Paduda

Thursday, May 25, 2017 | 2055 | 0 | min read

CompPharma’s second research paper on compounds in workers’ comp was published last week. Authored by pharmacists and government affairs professionals from member pharmacy benefit managers, this paper builds on the groundbreaking research published in our first paper. (Full disclosure: I’m president and co-founder of CompPharma).

Joe Paduda

Joe Paduda

The first research paper supplied a solid foundation to provide stakeholders with a deep understanding of the history, practice, limitations and issues associated with compounds.

This paper takes a deep dive into patient safety, efficacy and cost.

It also includes a review of many legal issues surrounding compounds in workers' comp, and details regulatory and legal cases involving allegedly inappropriate activity by compounders and prescribers.

A few key excerpts:

CompPharma supports the use of compounding when prescribed by a licensed practitioner with knowledge of evidence-based medicine supporting the use of a compound for a single patient with special needs that prevent the use of a drug approved by the Food and Drug Administration (FDA) [emphasis added].

... the use of topical compounded products is not recommended as first-line treatment for workers’ compensation patients [emphasis added].

CompPharma’s 2014 compound research paper stated, “Pharmacies have received FDA warnings regarding topical lidocaine in concentrations greater than 5% and other topical anesthetics.” Some compounding pharmacists responding to the 2014 paper characterized this statement as a misrepresentation. The authors stand by the statement …

… a chief criticism is that by acting as intermediaries, PBMs profit from the use of compounds and other over-priced medications. In reality, the clinical management programs employed by these companies actually decrease PBMs’ top-line revenue [emphasis added].

The first paper upset a few compounding advocates. Their complaints mostly arose because we didn’t address compounding outside of work comp. Frankly, the paper’s focus was, and the latest paper’s focus still is, purposely limited to workers’ comp. Others are welcome to address non-work comp issues; that’s not what we do.

You can download the paper here — there’s no charge or registration required.

CompPharma is proud to have been the leading force educating the work comp world about compound drugs. Thanks to member PBMs for supporting our work, and a special thank you to:

  • Phil Walls, RPh, myMatrixx.
  • Deborah Conlon, RPh, BS Pharm, PharmD, OptumRx.
  • Brigette Nelson, MS, PharmD, BCNP, Express Scripts.
  • Kevin Tribout, OptumRx.
  • Nikki Wilson, PharmD/MBA, Coventry.
  • Contributing Editor Robert E. Bonner, MD, MPH, Principal, Bonner Consulting Group LLC.

What does this mean for you?

Compounds can be useful and appropriate for patients with unique and unusual needs. This report provides objective, thoroughly researched information essential to understanding this issue.

Joe Paduda is co-owner of CompPharma, a consortium of pharmacy benefit managers. This column is republished with his permission from his Managed Care Matters blog.

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