The California Division of Workers’ Compensation’s (DWC) Pharmacy & Therapeutics Committee meeting took place on July 15th, and Healthesystems attended this meeting to monitor emerging formulary, utilization, and drug-spend trends.

The Committee continues to focus on high-cost and high-utilization medications, and although no action was taken at the meeting, ongoing reviews of medical necessity, prescribing patterns, and drug spend could affect medication access and pharmacy management strategies in California workers' compensation.

What follows are key pharmacy updates discussed:

• MTUS Formulary Version 14 RXCUI updates, including traumatic brain injury-related additions, gabapentin and rivastigmine revisions, and removal of ibuprofen 300 mg based on prior cost and clinical-value concerns
• Preliminary data on GLP-1 medications paid through California workers’ comp claims, prompting discussion about medical necessity and whether the related diagnoses clearly connect to the work injury
• Preliminary proton pump inhibitor (PPI) duration data, which identified data-quality issues requiring cleanup. Committee discussion focused on long-term use, clinical risks, medical necessity, and potential claim disruption if access is restricted, and whether a white paper or ACOEM resource could help address appropriate long-term use.
• Gabapentin and pregabalin continue to dominate utilization and spending, while most other products in these categories have limited utilization
• Committee members raised concerns about high-cost manufactured topical products and whether the DWC should review access or compare topical spending across MTUS drug categories
• Biologic trend data was unavailable due to a data-pull issue. The DWC will revisit utilization and spending trends

Additionally, the DWC reminded attendees of an upcoming pharmacist consultant opportunity and asked participants to share the posting with interested candidates.