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Oakland, CA – Part III of the California Workers’ Compensation Institute’s (CWCI) research series on low-
volume/high-cost drugs used to treat California injured workers highlights three Musculoskeletal Drugs and three Ulcer Drugs that represent a small share of the prescriptions in their therapeutic drug groups, but due to high average payments, have become cost drivers, consuming a disproportionate share of the total drug spend for their groups.
The new report is the last of a three-part research series that uses data from the Institute’s Prescription Drug Application to track changes in the distribution of California workers’ compensation prescriptions and pharmacy payments over the past decade, and to identify medications that have a disproportionate impact on the total amount paid for drugs within their group. The report notes changes in the average payment per prescription for the highlighted drugs over the 10-year study period (2012 through 2021), changes in the percent of the prescriptions dispensed as a brand rather than a generic drug, and factors that contribute to the high cost of the medications.
According to the report, Musculoskeletal Drugs were the sixth most prevalent drug category in 2021, with 5.9% of the workers’ comp prescriptions, but because low-cost medications like cyclobenzaprine (Flexeril), tizanidine HCl (Zanaflex), and Baclofen (Gablofen, Lioresal) dominate the category, Musculoskeletal Drugs accounted for just 3.7% of the total drug spend. At the same time, Ulcer Drugs, which were the seventh most common drug category, accounted for 5.4% of the prescriptions dispensed to injured workers in 2021, but 6.5% of the payments, even though nearly half of the prescriptions were for low-cost omezprazole (Prilosec). Within each of these two drug groups the study identified three low-volume/high-cost drugs that have had an outsized impact on the total reimbursements for the group. The Musculoskeletal medications highlighted in the report include:
The Ulcer Drugs highlighted in the report include:
CWCI has published more details and analyses on these drugs in a Spotlight Report, Cost-Driver Medications in the Top California Workers’ Comp Therapeutic Drug Groups: Part III, Musculoskeletal and Ulcer Drugs. Institute members and subscribers can log on to the Research section of the Institute’s website (www.cwci.org) to access this report, as well as Part I of the series, which covered Anti-Inflammatory and Anticonvulsant Drugs, and Part II, which covered Dermatologicals, Opioids, and Antidepressants. Others can purchase the reports from CWCI’s online store.