NCCI study finds changes in opioid drugs impact work comp costs

Prescribing Patterns for Drugs Have Mitigated Work Comp Medical Cost Increases

A recent report by the National Council on Compensation Insurance (NCCI) found that changes in prescribing opioids have impacted drug costs and cost trends for prescription drugs in workers’ compensation claims. Prescription drug costs are a large portion of medical expenses for workers’ compensation claims, making up about 7% of workers’ compensation medical costs.

The NCCI report found that payments for prescriptions had been steady through 2016 but, since then, have dropped significantly. Nationally, the average drug paid per claim has fallen 2.6% annually since 2012, totaling about a 21% decrease in the past 10 years. This is largely due to the type and number of prescriptions being prescribed. Specifically, prescription drug prices have increased annually by 3.7%, but with the decline in opioid prescriptions and the number of prescriptions being given, this annual rate has been offset by 6%.

Opioid Versus Non-opioid Claims

Treatment for workers’ compensation injuries often includes prescribing medications, both opioid and non-opioid. However, since the awareness of the opioid epidemic came to light, prescriptions of opioid medications have decreased nationwide. In fact, according to the NCCI report, workers’ compensation claims that included opioid prescriptions have decreased from 55% in 2012 to 26% in 2021. Still, due to these decreased opioid claims, non-opioid claims have risen from 45% in 2012 to 74% in 2021.

There has been a decrease in the prescription of opioids in workers’ compensation claims, including opioids prescribed together with non-opioids. This decrease indicates that fewer injured employees are being prescribed opioids. The increase in non-opioid prescriptions with no opioids at all shows that health care providers are using alternative treatments to manage pain. Overall, this trend towards decreased opioid use and increased non-opioid use is a positive development to offset the increased drug prices in the health care industry.

Overall Drug Costs

The overall annual drug cost per claim has decreased by 2.6%. The opioid claims have decreased annually by about 3.8%. The claims for non-opioid drugs add 1.3% annually on average to drug costs. These results show that the shift in the opioid and non-opioid claims reflects the changes in drug prices and utilization.

With all of these changes, it is apparent that changes in prescribing patterns, especially since the opioid epidemic, have offset prices in the workers’ compensation setting. In doing so, increased medical costs have been mitigated over the past 10 years.

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