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Texas Workers’ Comp informal rule addresses compounded drugs

To combat the increased cost of compound medications the Texas Division of Workers' Comp has issued an informal rule regulating when such medications can be used in workers' comp cases.

By Rosalie L. Donlon | Updated on July 04, 2017
Some patients require compound medications, but the cost in many states has increased dramatically. (Photo: Shutterstock)

A major cost component of all employer health plans is the price of prescription drugs. Most health plans include formularies with tiers for generic and name-brand drugs, and the plans also include options for compounded drugs, defined by the Professional Compounding Centers of America as medications made based on a practitioner’s prescription in which individual ingredients are mixed together in the exact strength and dosage form required by the patient. The cost of compounded medications is also driving up workers’ compensation costs across the country.

In the state of Texas, for example, a House committee asked the Division of Workers’ Compensation (DWC) to look at compounded drug prescriptions for injured employees. The division examined its data on pharmacy billing and an ongoing audit of doctors’ practices, and it found that the cost of compounded drugs doubled from 2010 to 2014, and the average cost per prescription had risen to $829 in 2016.

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