Report highlights high costs of alternatives to opioids

Some types of non-opioid anti-Inflammatory and anticonvulsant medications prescribed to injured workers have become “significant cost drivers” in workers comp, according to a report issued Monday by the California Workers’ Compensation Institute.

CWCI’s analysis sought to identify non-opioid pain-relief medications with high average reimbursements that have an outsized impact on the total payments within their drug group, noting changes in the average amounts paid per prescription for each of these drugs from 2012 to 2021.

Highlighted were low-volume, high-cost fenoprofen calcium, with an average payment of $1,479 per script, and ketoprofen, with an average payment of $1,073 per script, which kept anti-Inflammatories at the top of the list in terms of total drug spending.

Fenoprofen calcium represented 1.4% of the 2021 anti-Inflammatory prescriptions but 33.2% of the payments. Ketoprofen represented 0.6% of the prescriptions but 9.8% of the payments.

Fenoprofen calcium also represented just 0.5% of all workers compensation prescriptions in 2021 but 8.1% of the total drug spending within the system, by far the largest percentage of any single drug.

The analysis also found that four anticonvulsant drugs — lacosamide, levetiracetam, lamotrigine, and pregabalin — accounted for 24.2% of the 2021 anticonvulsant prescriptions, but 72.5% of anticonvulsant drug expenditures.