Cambridge, MA, March 30, 2023―A new series of studies from the Workers Compensation Research Institute (WCRI) examines the impact of formularies on prescription drug utilization and costs in five states (Arkansas, California, Indiana, Kentucky, and New York) that implemented formularies in 2018 and 2019. They also examine the effect on physician dispensing and generic utilization in states with applicable formulary rules.

“These studies can help policymakers and other stakeholders understand the impact of implementing various types of drug formularies on prescriptions provided to workers with newer work-related injuries and on associated prescription drug costs in their state workers’ compensation systems,” said John Ruser, president and CEO of WCRI. 

All the studies answer the following questions:

• Did the formulary reduce overall prescription utilization?
• What was the impact on drugs with different status under the workers’ compensation drug formulary? For example, was there a differential effect on non-exempt, exempt, and unlisted drugs under the California Medical Treatment Utilization Schedule (MTUS) formulary?
• What was the impact on various drug groups—opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), dermatological agents, musculoskeletal therapy agents, anticonvulsants, compounds, and others?
• Did the formulary reduce prescription payments per claim?

As the formulary in each state is distinct, readers are advised to take the differences in formulary design and regulations into account when making comparisons across reports examining the impact of the drug formularies in different states. In addition, prescription drug use and costs before the formulary, drug policies in the state, and other workers’ compensation policies that may interact with the enforcement of the formulary rules may also contribute to the differential impacts of the drug formularies.

To learn more about or to download these five individual studies, visit https://www.wcrinet.org/reports/monitoring-trends-after-adoption-of-drug-formularies. Vennela Thumula and Te-Chun Liu authored these studies.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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