Dermatologicals Become the Costliest Drug Group in California Workers’ Compensation

January 13, 2025 – Dermatologicals Costliest Drug Group: Recent findings from the California Workers’ Compensation Institute (CWCI) reveal significant changes. These changes are in the drug prescription patterns for injured workers in California. Notably, anti-inflammatory medications remain the most frequently prescribed drugs, while dermatologicals have emerged as the most expensive drug group, driven by high-cost, private label options.

Prescription Trends and Reimbursements

Dermatologicals Costliest Drug Group: CWCI’s latest data from its Prescription Drug Interactive Application ranks the top 10 therapeutic drug groups based on prescription volume and total reimbursements. Analyzing data from 2016 through June 2024, CWCI experts noted a correlation between the decline in opioid prescriptions and the implementation of new guidelines. Specifically, the Opioid and Pain Management Guidelines were added to the Medical Treatment Utilization Schedule (MTUS) in late 2017, followed by the introduction of the MTUS Formulary in 2018.

Anti-inflammatory drugs, including ibuprofen and naproxen, surpassed opioids in 2016 to become the leading drug group. By 2021, they accounted for a record 35.3% of all prescriptions for injured workers in California. Ibuprofen’s share increased from 32.9% of anti-inflammatory prescriptions in 2017 to 42.2% in 2021, stabilizing thereafter. In 2023, ibuprofen represented 14.1% of all prescriptions, maintaining its dominance over naproxen, which held 8.2% of the prescriptions.

In contrast, opioid prescriptions have significantly declined, falling to 7.9% of prescriptions in 2023, a sharp drop from 22% in 2016 and 30.8% in 2010. This decrease aligns with stricter opioid regulations and increased reliance on non-narcotic alternatives.

Rise of Dermatologicals

Dermatological drugs, used primarily to manage pain, have seen significant growth. Their share of workers’ comp prescriptions surged from 4.9% in 2016 to 12.6% in the first half of 2024. This growth is largely attributed to increased prescriptions for lidocaine and diclofenac sodium, which together rose from 46% of dermatological prescriptions in 2016 to 81.6% in 2024.

The decline in musculoskeletal drugs, from 10.7% of prescriptions in 2016 to just over 6% in recent years, also reflects the impact of the MTUS Formulary, which limits the use of these drugs to specific circumstances.

Shifts in Drug Spending

The shift in drug utilization patterns has also influenced spending. In 2024, the top 10 drug groups accounted for 78.3% of total drug expenditures, closely mirroring the 78.8% share in 2016. Nevertheless, the distribution of spending has changed dramatically. Dermatological drugs now consume a significant portion of the drug budget, surpassing anti-inflammatories and opioids.

In 2016, opioids accounted for 18.2% of drug payments, but this figure plummeted to 4.9% in the first half of 2024. Meanwhile, anti-inflammatories’ share of the drug spend peaked during the pandemic, reaching 25.1% in 2021, before declining to 17.4% in 2023. Dermatological drugs overtook anti-inflammatories, representing 18.9% of the drug spend in 2024.

Other Notable Trends

Anticonvulsants, used for neuropathic pain, surpassed opioids in 2022 to become the third most prescribed drug group. Antidepressants followed in 2023, now holding the fourth position. Migraine drugs, despite being 13th in prescription volume, ranked as the fourth costliest group due to high-priced, brand-name options. Their share of spending climbed from 0.5% in 2018 to 6.7% in 2024.

Top Drug Ingredients by Cost

In the first half of 2024, lidocaine emerged as the top drug by total payments, accounting for 8.5% of the total drug spend, followed by naproxen and pregabalin. Diclofenac sodium and meloxicam, along with the migraine drug rimegepant sulfate, rounded out the top six.

For a detailed analysis, visit the full report on CWCI’s website. For more insights into workers’ compensation and related medical-legal news, visit MedlegalNews.com.

Source

California Workers’ Compensation Institute (CWCI)

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