Workers compensation payments in all drug categories — including opioids — dropped in 25 of 27 states studied by the Workers Compensation Research Institute over the last three years, and dermatological agents are making up a larger percentage of the drug spend in many states.

Researchers at the Cambridge, Massachusetts-based WCRI evaluated workers compensation drug payments in the first quarters between 2015 and 2018 based on drug type — opioids, non-steroidal anti-inflammatory drugs, dermatological agents, anticonvulsants, musculoskeletal therapy agents and compounded drugs. The study revealed that medical claims decreased 15% in all states studied except Louisiana and Mississippi, and that the payment for compounds, which have been more prominent in some states, now accounts for a very small percentage of workers comp prescription payments.

Opioid drug spend in the first quarter of 2018 ranged from a low of 9% of all drugs in Florida, Illinois and Virginia to a high of 19% in Kansas, among states studied, but all states reported a drop in the percentage of money spend on opioids over the course of the three years. Anticonvulsants grew modestly, according to the study, with 12 of the 27 states reporting payment increases of at least 3% for drugs in that category, but musculoskeletal therapy agents and NSAIDs changed little in any of the states.

However, payments for dermatological agents have grown and drugs in this category made up nearly a third of the drug spend in Pennsylvania during the first quarter of 2018 and made up 43% of the drug spend in Illinois during that same quarter. In 17 of the 27 states studied, payment shares in this category increased by at least 3% and dermatological agents accounted for about 14% of the workers comp drug spend in all states studied in early 2018.

The 27 states included in the WCRI study are Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin.