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Modest increase in 2014 workers’ comp pharmacy costs reported

Pharmacy costs, which account for about 18 percent of total workers’ compensation medical spend, increased 1.9 percent last year, according to Express Scripts’ newly released 2014 Workers’ Compensation Drug Trend Report. 

The annual report features data on overall pharmacy trends and opioid use among injured workers. Key findings include:

  • A 5.4 percent decrease in utilization helped offset a 7 percent increase in cost per prescription.
  • Compounded (personalized) medications cost an average of $1,696 per prescription. Pharmacies that compound more than two-thirds of prescriptions increased their prices 51.5 percent, while those that compounded less than 67 percent of total prescriptions averaged a 9.7 percent price increase.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat pain and inflammation increased 13.4 percent at an annual cost of $158 per user.
  • Prescriptions for antidepressants and dermatological medications decreased 19.6 percent and 10.9 percent, respectively.

Opioids

Opioid use among injured workers decreased nearly 11 percent; total spending on opioid medications remained flat (-0.5 percent) at $487 per user. Patients receiving a Morphine Equivalent Dose (MED) dose of 100 milligrams or more per day had a nine-fold increase in overdose risk. Patients with long-term disability (15+years post injury) exceeded the MED of 120 milligrams per day at least half the time.

“Although older injuries may require higher doses of opioids because the patient has become tolerant to previous doses, patients receiving an MED of 100 milligrams or more raises serious concerns about the potential of addiction and abuse,” said Brigette Nelson, PharmD, senior vice president, Workers’ Compensation Clinical Management at Express Scripts. “Better management of opioid use among injured workers helps reduce abuse, limit addiction and control costs.”

Express Scripts annually manages more than a billion prescriptions for employers, health plans, unions and government health programs. Workers’ compensation data are carved out of this total.