{"id":167361,"date":"2024-05-15T03:00:00","date_gmt":"2024-05-15T03:00:00","guid":{"rendered":"https:\/\/www.mtmic.com\/blog\/?p=167361"},"modified":"2024-10-17T01:13:23","modified_gmt":"2024-10-17T01:13:23","slug":"the-cost-of-getting-better","status":"publish","type":"post","link":"https:\/\/www.mtmic.com\/blog\/2024\/05\/the-cost-of-getting-better\/","title":{"rendered":"The Cost of Getting Better"},"content":{"rendered":"\n

By Donna Motley,
Vice President of Claims<\/em><\/p>\n\n\n\n

I recently reviewed a new claim that crossed my desk for a \u201cfoot contusion\u201d \u2013 a 14 pound part fell on the top of the employee\u2019s foot. Fortunately, no bones were broken, but there was an abrasion with minimal blood, bruising and swelling. A trip to the local occupational clinic consisted of the examination, an x-ray and prescribing of the following: Bacitracin Ointment (an anti-biotic), Cephalexin (an oral anti-biotic), Naproxen (an antiinflammatory), Tylenol Extra Strength, an Ace Bandage, home dressing supplies, hot\/cold pack, and a post-op shoe; also with a referral to physical therapy. Work restrictions were imposed with a return clinic visit in two days.<\/p>\n\n\n\n

After two days, the return visit showed improvement, but the employee was to remain on the above prescribed protocol with a return visit in one week. At the one week return visit, cellulitis was diagnosed (a bacterial infection); Sulfamethoxazole (an anti-biotic) was prescribed; work restrictions remained in place.<\/p>\n\n\n\n\n\n\n\n

In the grand scheme of work-related injuries, this injury would be considered to be relatively mild in nature. I\u2019m sure the employee had pain and suffered some limitations, but treatment was provided by the occupational clinic, not a hospital or by a specialist (although we will keep our fingers crossed as the injury\/condition has not resolved). A lot of medicinal treatment. The United States spends the most, per capita, on prescription drugs compared to other countries. Is this over-kill? I know if I\u2019m sick or not feeling well, I want to be \u201cfixed\u201d as soon as possible. I think that is our motto \u2013 give me a pill so I can be better. We can all think back to a couple of years ago with COVID.<\/p>\n\n\n\n

Needless to say, pharmaceutical companies have been under the microscope by our government because of the high cost of prescription drugs. Pharmaceutical companies point to the high cost of Research & Development, clinical trials and the cost of obtaining FDA approval as being cost inflators. Not to mention, not every drug is successful in making its way into circulation so the money spent is for nothing. Once approved, a Patent is obtained on the drug. Patents usually run for 20 years in the U.S. A Patent means only the pharmaceutical company that holds the Patent is allowed to manufacture and market the drug and make a profit from it. Having a Patent eliminates generic versions of said drugs. Once the Patent expires, the price of the drug drops.<\/p>\n\n\n\n

In the interim, there are cost saving programs available. Good RX is one of them \u2013 they will list the selling price of a drug at multiple locations. As an example, on a claim I\u2019m handling, the injured worker was prescribed Gabapentin for nerve pain. The listing price was $141.55 \u2013 our Workers\u2019 Compensation Pharmacy Benefit Manager priced it at $96.57. Good RX listed Gabapentin at $9.73 at Meijer, $11.21 at Kroger and $16.72 at Walmart. That is quite a difference!<\/p>\n\n\n\n

Several drug Patents due to expire within the next five years are: Keytruda (cancer), Eliquis (blood clots), Xarelto (blood clots), Trulicity (diabetes) and Prevnar 13 (streptococcus, pneumonia & bacteria).<\/p>\n\n\n\n

The bad news \u2013 the Patent on Ozempic (intended for diabetes but being used for weight loss\/control) \u2013 does not expire until 2031 \u2013 and even with Good RX, the current cost is approximately $1,000!<\/p>\n","protected":false},"excerpt":{"rendered":"

By Donna Motley,Vice President of Claims I recently reviewed a new claim that crossed my desk for a \u201cfoot contusion\u201d \u2013 a 14 pound part fell on the top of the employee\u2019s foot. Fortunately, no bones were broken, but there was an abrasion with minimal blood, bruising and swelling. A trip to the local occupational…<\/p>\n","protected":false},"author":1,"featured_media":167363,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-167361","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-claims"],"jetpack_featured_media_url":"https:\/\/www.mtmic.com\/blog\/wp-content\/uploads\/2024\/10\/2024-05_art3-image1.jpg","_links":{"self":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts\/167361","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/comments?post=167361"}],"version-history":[{"count":1,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts\/167361\/revisions"}],"predecessor-version":[{"id":167364,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts\/167361\/revisions\/167364"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/media\/167363"}],"wp:attachment":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/media?parent=167361"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/categories?post=167361"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/tags?post=167361"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}