Commissioner Tamara Nance of the North Carolina Industrial Commission spoke recently at the North Carolina Bar Association’s Workers’ Compensation Section Annual Meeting and told the audience that prescription drug formularies are being studied for possible future introduction into the North Carolina workers’ compensation system.  A drug formulary is a list of prescription and non-prescription drugs which are appropriate for treatment of compensable injuries and conditions and which may offer good economic value.  A formulary typically allows healthcare providers and patients to ascertain which drugs are automatically covered by a health plan and which drugs will require further authorization or will not be covered by a health plan.

The North Carolina General Assembly has directed the Industrial Commission to prepare a study on the implementation of a drug formulary in workers’ compensation claims filed by state employees.  The purpose of the study is to determine if the use of a drug formulary will result in a more efficient, cost saving delivery of medications in claims filed by state employees.  The report is to be submitted to the General Assembly by April 1, 2016.

Depending upon the results and outcome of the study, drug formularies could be implemented on a broader scale in North Carolina. Presently, only the states of California, Ohio, Oklahoma, Texas, and Washington have state-regulated drug formularies in place.  It will be interesting to see the outcome of this study and if the Industrial Commission and General Assembly move forward with additional steps toward implementation of drug formularies.  Cranfill, Sumner & Hartzog will provide future updates on this topic.