Workers compensation pharmacy spending decreased 6.1% in 2019, a decline attributed to a number of factors including fewer opioids, more generic drugs, and lower costs via home delivery, according to new data released Wednesday by Matrix Healthcare Services Inc., a Tampa, Florida-based pharmacy benefits manager doing business as myMatrixx.

Payers with a workers compensation program managed by myMatrixx also experienced a 4.3% decrease in the number of prescriptions, according to the report.

The new data also shows that individual prescription drug costs decreased 2.4% in 2019, despite a 1.9% increase in drug utilization in comp. MyMatrixx attributed the “apparent discrepancy” to the “age of claim effect,” which finds that claimants with 10 or more years of drug utilization have almost seven times greater days’ supply of medication than claimants during their first year following an injury, according to the report.

In line with other comp trends reports, average spending on opioids declined by 10.7% for payers between 2018 and 2019, with an overall payer spend on opioids between 2015 and 2019 declining by 45.1%. In addition, injured workers are taking opioids for shorter periods: in 2019, 14.7% of injured workers used opioids for 30 or more days, down from 17% in 2018, the report highlights.

A push for generic substitution of the popular name brand drug Lyrica, which the U.S. Food and Drug Administration approved for generic distribution mid-year 2019, likely contributed to the decline in drug spend, as MyMatrixx clients saw 91.8% of the more-expensive Lyrica prescriptions converted to generic pregabalin within four weeks and 96.4% within 180 days of the approval, according to the report.

Home delivery of drugs to injured workers also factored into the decline in drug spend, with the delivery method yielding a 23% decrease in average drug costs when compared with pharmacy-filled medications, according to the report.

The trend toward specialty drugs is also a focus for payers: the report states that only 2.1% of injured patients used a specialty drug in 2019, yet the costs accounted for 8.8% of total pharmacy spend. Specialty drug claims in workers comp typically include anticoagulants and therapies for HIV, hepatitis C and oncology. In 2019, spending on HIV drugs — typically covered following a needle-stick exposure by health care workers — increased 22.1%, driven primarily by a 16.2% rise in utilization, according to the report.

Private-label topical creams are also a concern, as the report highlights such topicals account for 12% of physician-dispensed drugs and 35.4% of the total spent on physician-dispensed medications.