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Workers comp drug prices rise as utilization falls

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A decrease in utilization offset rising drug prices in 2015, leading workers compensation prescription drug spending per worker to increase 2.2%, according to pharmacy benefit manager Express Scripts Inc.

As a result of the average cost per prescription increasing 4.4% and utilization decreasing 2.6%, Express Scripts reported an overall drug trend of 2.2% in 2015, compared with 1.9% a year prior, the St. Louis-based pharmacy benefit manager said Tuesday in its 2015 Workers' Compensation Drug Trend Report.

Nine of the 25 most commonly dispensed medications in 2015 were opioids, which continue to be the most expensive and highly utilized class of drugs for injured workers despite a 10.9% overall decrease in utilization, the report states.

Meanwhile, dermatologicals like lidocaine and muscle relaxants like cyclobenzaprine both saw “substantial increases” in average cost per prescription at 15.8% and 10.1%, respectively, according to the report.

The cost per prescription for compounded medications also increased 6.6%, compared with 35% in 2014, Express Scripts said in the report, adding that the average cost to workers comp payers for a compound prescription in 2015 was $1,769.45.

Workers comp payers spent an average of $1,590.99 per injured worker for prescription medications in 2015, according to the report.

Similar to opioids, the utilization of compounded medications decreased 38.8% from 2014 to 2015, the report states.

High blood cholesterol drugs, nonsteroidal anti-inflammatory drugs and anticonvulsants were the only three therapy classes in the top 10 workers comp drug classes that saw increases in utilization last year.

“The impact of new medications on payers' costs was minimal in 2015, as only a few medications with significant costs were brought to market in late 2014 and 2015,” Express Scripts said in the report. “Harvoni, a specialty antiviral medication used to treat hepatitis C, was one of these few high-cost medications, but low use of these medications among injured workers minimized the effect on trend.”