In its most recent annual survey of the Top 25 Drugs in Workers' Compensation, The Hartford reports that overall pharmaceutical costs for its workers' compensation clients decreased during 2005. This dip, according to the company's research data, is linked in part to the greater availability of generic substitutes, especially for the most popular and expensive name-brand drugs.

"The emergence and increased use of generic substitutes for OxyContin and Neurontin , two of the more expensive and widely used drugs for treating pain in workers' compensation cases, is having a significant effect on pharmaceutical costs," said Dr. Robert Bonner, medical director for The Hartford. "In addition, the withdrawal of the popular Cox-2 inhibitors Bextra and Vioxx, which were frequently taken to manage pain and inflammation, is helping to drive down pharmacy costs for patients receiving care under this system."

While The Hartford had been reporting progressively smaller annual increases since the first study was published in 2001, this past year marked the first time ever that costs actually declined slightly -- by about 1 percent.

"Beyond a shift to some key generic drugs, The Hartford's pharmacy management and extensive claims review process also have contributed to this downturn in costs," said Bonner. "Still, we shouldn't presume this decline is the beginning of a trend, especially as more drugs are being prescribed and overall pricing continues to rise."

The Hartford's Top 25 Drugs in 2005 Workers' Compensation

(Ranked by Total $ Costs)

1. OxyContin

2. Gabapentin

3. Hydrocodone

4. Lidoderm

5. Celebrex

6. Actiq

7. Oxycodone

8. Mobic

9. Duragesic

10. Ambien

11. Skelaxin

12. Tramadol

13. Fentanyl

14. Cyclobenzaprine

15. Topamax

16. Tizanidine

17. Carisoprodol

18. Effexor

19. Oxyco/Apap

20. Neurontin

21. Naproxen

22. Avinza

23. Propoxyphene

24. Percocet

25. Morphine

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