Welcome back to this week’s look back at 2019 drug trends for compound kits and combo packs. Let’s start with a brief look at what we are describing when we refer to compound kits and combo pack products. Compound kits are products that contain two or more pre-measured drug ingredients that are combined prior to use based on a prescription order and are sold as one product. Whereas combo packs contain multiple commercially available products that are conveniently packaged together for sale with a common therapeutic purpose. Both of these product categories present challenges to the workers’ compensation industry because they don’t have Food and Drug Administration (FDA) approval and often do not demonstrate superiority to individual products.
Fortunately, First Script® has seen a decrease in compound kit usage (by scripts per claim) in each of the last 5 years and overall use of both categories continues to account for less than 1% of total script volume and costs. However, this past year did see an increase in cost per script due to a shift in mix of compound kits used. This includes the following compound kits: VP GKL cream kit, VP FC cream kit, and Lidopure 5% kit, all of which are over $1000 per fill and none of which were seen in 2018. In regard to combo packs, usage decreased 2.4% compared to 2018 but this was offset by an increase in cost per script of 2.5%, which resulted in the cost per claim increase of less than 0.5%. This is important to note because the cost per claim had previously increased by much larger amounts in each of the previous 4 years.
Now let’s take a look at examples of combo packs that were seen last year and a breakdown of their cost and ingredients:
As we can see compound kits and combo packs are high impact classes owing to the exorbitant costs often associated with these products and are also of increasing importance due to the decline of traditional compound utilization and cost. First Script has developed clinical oversight programs to help clients identify and clinically manage price opportunist drugs. Overall, these programs ensure use of these medications are clinically appropriate and places points of control prior to dispensing to help drive towards best practice pharmacy management.