Workers' compensation claims seeing fewer opioid prescriptions

Migraine medications, which saw utilization increase 17%, also had one of the largest cost increases.

Enlyte reported that spending on specialty drugs, such as HIV and cancer medications, has nearly tripled during the past six years. Although they make up for less than 2% of total prescription volume, specialty drugs now account for more than 15% of total spending. Credit: wollertz/Adobe Stock

In 2023, opioid utilization in workers’ compensation claims saw one of its largest declines in recent years, according to Enlyte Group, LLC. Utilization declined 9.7% per claim and cost decreased 7.2% per claim.

Opioid alternatives are also seeing declining utilization per claim, although to a lesser extent, Enlyte reported. For example, utilization of non-steroidal anti-inflammatory drugs dropped 3% and anticonvulsants saw declines of 7.4%.

During the past year, eight of the top 10 therapeutic drug classes saw prescription costs increase, with two classes seeing increases of more than 10% in costs. However, Enlyte reported utilization fell per claim in every class except medications to treat migraines.

Migraine medications, which saw utilization increase 17%, also had one of the largest cost increases (10.2%). Only respiratory medications saw a bigger cost increase, with prices increasing 14.7% on a per script basis. Enlyte reported that both classes of drugs were among the top five therapeutic classes to see brand average wholesale prices increase this past year.

“Basically, what’s driving these trends are the costs of the top three medications in their respective classes,” Nikki Wilson, Enlyte’s senior director of clinical pharmacy solutions, said in a release. “For instance, for migraine medications, Nurtec ODT is prescribed about 15% of the time yet makes up more than 31% of the total drug spend in this category.”

Ubrelvy made up 15.9% of total migraine spending in workers’ comp claims, while being prescribed about 8.5% of the time.

“Similarly, respiratory medication like Trelegy Ellipta is prescribed about 10%, but accounts for nearly 19% of all respiratory medication total costs,” Wilson said.

Enlyte also reported that spending (as a percentage of overall prescription spending) on specialty drugs has nearly tripled during the past six years.

Although they make up for less than 2% of total prescription volume, specialty drugs now account for more than 15% of total spending. The average wholesale price for specialty drugs, which include hematological, HIV and cancer medications, increased 3.3% this past year.

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