Report zeros in on impact of high-cost drugs in comp

A handful of drugs prescribed to injured workers in California make up a “disproportionate” share of workers comp prescription payments, according to research released Monday by the California Workers’ Compensation Institute.

The so-called “low-volume/high-cost” drugs include dermatological drugs, opioids and antidepressants and have become cost drivers, the researchers found.

The report says topical dermatologicals, the fourth-most prevalent drug category in 2021, accounted for 9.3% of workers comp prescriptions but 17.3% of all prescription drug payments. That was up from 12.8% of payments in 2012, which the study ascribes to increased use and the emergence of high-priced topical analgesics.  

Opioids’ share of overall prescriptions continued to drop, with the total drug spend falling to 5.8%, down from 26.7% a decade earlier. During the same period, the mix of opioids used to treat injured workers shifted, and the study noted three low-volume/high-priced opioids that have become cost drivers within their group, including oxycodone, a popular and strong pain medication. 

The top four antidepressants dispensed to injured workers in 2021 represented nearly 2/3 of the antidepressants used, but all four were relatively low-cost drugs, accounting for only 42.5% of the payments in that drug group.