Although usage rates and related costs have declined over the past few years, opioids still dominate California’s workers’ compensation prescription scene according to a press release from California Workers’ Compensation Institute (CWCI). They are the top category of prescriptions for injured workers, not just in California but in the country.
Opioids make up over a quarter of the state’s prescriptions, at 27.2 percent of total distributions. Anti-inflammatory drugs follow with 18.7 percent, and musculoskeletal therapy drugs make up 9.3 percent. Anticonvulsants, antidepressants, ulcer drugs, and dermatology drugs also make up small percentages and other drugs take up the remaining 20.3 percent.
The study from CWCI looked at volume, cost, type of drug and potency data taken from 10.8 million prescriptions written between 2005 and 2014. Their data showed that in the period between 2005 and 2009 opioid prescriptions increased from 27 percent of all prescriptions written to 31.8 percent. By 2014 that number had dropped back to 27.2 percent. Pharmacy spending increased and decreased in accordance with prescription rates. With the passing of SB 863 in 2012, the use of utilization reviews and independent medical reviews increased in California, and payers and pharmacy benefit managers started to put greater restrictions on opioid prescriptions which may help to explain why opioid usage started to decrease.
In the study period, researchers found that payments for all the prescriptions written cost $1.1 billion, and opioids made up $300 million of that spend. During that time, the average cost for opioid prescriptions increased by 85 percent, and costs for other kinds of prescriptions increased just 39 percent. Hydrocodone is the most prescribed opioid in the state, with 14.5 percent of prescriptions written in 2014. Tramadol prescriptions are increasing, making up 5.7percent of prescriptions in 2014. Oxycodone also grew from .7 percent of prescriptions written in 2005 to 3.2 percent in 2014, although it represented 6.9 percent of costs while hydrocodone represented 6.1 percent, even though it had a higher proportion of prescriptions.
The study is another look at just how prevalent opioids are in workers’ comp, and it does show that some states are taking measures to try and decrease prescriptions. Though they have decreased somewhat in California, there is still much work to be done.