ORLANDO, Fla.--The National Council on Compensation Insurance actuaries said yesterday that their 2007 study of prescription drug use to treat injured workers unexpectedly found that utilization of such medications fell for the second year in a row.

"A big surprise," said NCCI Senior Actuary Barry Lipton, speaking at a session of the NCCI's annual issues symposium here.

Increased utilization, Mr. Lipton explained, involves increased amounts of medication or more expensive drugs.

In addition to a reduction in utilization, Mr. Lipton said there was a drop by five points in the cost share of expensive name brand anti-inflammatory and analgesic drugs over the past two years.

According to the findings, anti-inflammatory drugs that were 25 percent of total medical costs in 2003 have seen their share of costs drop by 10 percentage points. He reported that use of less costly generic drugs in 2006 was 90 percent, up slightly from the previous year.

Mr. Lipton said the sudden drop in utilization is "like screeching on the brakes," and he suggested that more positive cost trends for comp insurance could be in the offing if more generic drugs are developed to replace "blockbuster" name brand prescriptions.

He went on to say that if "there aren't new designer drugs coming out, sooner or later there will be a generic for everything."

The NCCI study listed the top 10 drugs used for workers' comp treatment in 2006, in order, as:

o Hydrocodone/Acetaminophen

o Lidoderm

o Gabapentin

o Celebrex

o Oxycondone HCL

o Carisoprodol

o Actiq

o Skelaxin

o Oxycontin

o Naproxen

One drug, Actiq, Mr. Lipton described as a "hugely expensive" narcotic normally used to treat end stage cancer. He suggested that comp insurers should challenge its use, saying "someone needs to push back when there are signs of abuse."

He noted that while the pain killer Oxycontin had dropped from third place to ninth in 2006, it was actually in first place if the share of the similar generic Oxycondone was factored in.

Use of the name brand anti-inflammatory Mobic fell, while use of Lyrica shot up, the study found.

Harry Shuford, the NCCI's chief economist, reported on a study of the increasingly larger share medical plays in the cost of total workers' comp benefits. Among the factors mentioned was the finding that medical prices were rising faster than the rise in average weekly pay, which makes up the indemnity portion of comp payments.

The NCCI study, he said, found that the reasons for higher medical costs were hard to pin down. "It's not just [increased] surgery; it's a complicated problem." The one certain cost driver, he said, is that "doctors are delivering a lot more services."

Special Reports /

Workers' Prescription Drug Utilization Fell In '06

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