Compounds is a term being thrown around a lot when it comes to workers' compensation and medical treatment in general. But why is it getting so much attention?
Compound medications, or compounding, refers to the process of creating a custom medication to treat a patient’s individual medical condition. To create a compound, a physician determines the exact amount and combination of drugs to be used to meet a patient’s need and then a certified pharmacist creates the drug. There are a lot of reasons doctors may prescribe compounds - sometimes patients cannot swallow pills so a topical cream would work better, or a patient is allergic to one ingredient in a mass manufactured medication, and sometimes a compound can just help remove some of the negative effects of opioids.
So why so much attention? Well, it’s complicated. Although there are legitimate benefits and uses for compounds, there are almost as many cons. Compounds tend to be more costly than traditional drugs, meaning compounds are often linked to higher health care costs. A recent study in Texas found that since 2011, more compounds have been dispensed and at higher costs than ever before, and the increased use of those compounds has not been shown to be any more effective for patients than traditional prescriptions. There are also concerns about oversight of compounding, while manufacturing of traditional medications is a heavily regulated industry, the actual compounding of medication is far less regulated which means quality of a compound is more unpredictable.
Compounds are complicated and states are working hard to find a balance between the genuine need and benefits of compounds and ensuring patient safety and limiting fraud and abuse. In recent years states have placed caps on how much you can be paid for a compound, and in some cases, requiring doctors to prove a compound is medically necessary. Going into the 2017 legislative year, compounds will likely resurface as an issue states are looking at, including Texas, who’s Department of Insurance has been studying the use of compounds in workers’ comp over the last 6 months.