Comptroller: Rule for doctor backing of compound medications saves state health plan millions

Restrictions imposed on the rapidly rising use of compound drug prescriptions in the state health plan have cut spending by about $2 million a month, state Comptroller Kevin Lembo said Monday.

The use of compound drugs has been questionable, with some of the drugs expensive and untested, Lembo said at a news briefing at the Capitol.

The cost in claims to the state health plan has skyrocketed to $24 million this year on an annualized basis, from $800,000 in 2012, he said. "So that will get anyone's attention under any circumstances," he said.

Total spending on compound prescriptions has dropped from a high of $3.1 million a month in April to $36,229 per month in July, Lembo said. And average monthly compound drug prescriptions have dropped from $785 per month to $221 per month.

Lembo began requiring doctors in May to certify that a compound medication is necessary before the plan will pay for it. The result was an "immediate drop" in the number of prescriptions and dollar amounts, he said. Most of the medicines are used for pain or scar tissue, he said.

The average price of compound drugs also has dropped to $195, from $3,285. "What we're seeing is a return to traditional compounding" for infants who are allergic to dyes or elderly patients who can't swallow a medication, Lembo said.

Price increases were partly driven by new, out-of-state pharmacies, he said. In addition, "some unscrupulous companies saw an opportunity to fleece the system," he said.

Pharmacists create compound medicines by combining two or more drugs that are in some cases an expensive and untested topical pain medication or scar cream. Topical compound drugs are not approved by the U.S. Food and Drug Administration and use ingredients that have not been tested for safety and efficacy in a topical form, Lembo said.