Prescriptions for opioids and compounds continue to decline in work compensation, but dermatological drugs – especially drug-dosed drugs – continue to be a cost driver, according to the Workers Compensation Research Institute.
Preliminary data from 28 states showed that dermatology's share of payments increased from 11% in 2015 to 21% in the first quarter of 2020, while opioids' share of payments decreased during the same period from 21% to 8%. Cambridge, Massachusetts-based WCRI presented the research on Tuesday at its virtual annual problem and research conference.
"Associations, once a leading cost driver for prescription drugs, also declined significantly," said Vennela Thumula, WCRI's policy analyst, who noted that the substances' share of payments fell from 1
For example, the proportion of prescriptions for dermatologists peaked at 40% in South Carolina, but accounted for only 4% of payments in Iowa, where all dermatologicals were distributed. In South Carolina, as well as Georgia, Illinois and Maryland, about three-quarters of dermatological drugs were dispensed, according to early WCRI research.
In the dermatological category, prescriptions for diclofenac sodium gel accounted for the majority of prescriptions in the median mode, Thumula said, and lidocaine was also frequently prescribed.
While about 56% of workers prescribed topical diclofenac had documented diagnoses of soft tissue damage in the joints – for which the drug is approved – about 40% of workers used it for treatment that was not recommended, often for shoulder and back pain, she said.
Another cost driver in dermatological drugs is private-label topicals, which are manufactured independently and are not recommended by evidence-based guidelines and "also have a much higher price tag compared to comparable products" approved by the official Disability Guidelines Workers' Compensation Drug Forms, also known as ODG, Ms Thumul et al. Carolina, and it's even higher in Delaware, "she said.