The acceleration of prescription drug costs for workers' compensation systems and other payers is finally showing signs of moderating, the National Council on Compensation Insurance reports in a study due for release on Monday.
NCCI said that in 2004–their most recent data–the rate of increase was 8.2 percent, down two points from 2003 when the rate was 10.2 percent, and nearly half of the 14 percent rate of increase in 2002.
Among reasons cited for the slowed increase by the Centers for Medicare and Medicaid Services are:
o Growth in the use of lower-priced generic drugs through tiered benefit plans.
o Increased over-the-counter use of antiulcerants and antihistamines.
o A shift towards dispensing more drugs through mail-order systems.
o A reduction in the use of some non-generic prescription drugs because of safety concerns–notably increased risk of heart attack and stroke from anti-inflammatory medicines Celebrex, Vioxx and Bextra.
The NCCI researchers said the soaring increase in prescription drugs as a share of total medical costs for workers' comp may finally be abating.
The share of prescription drugs in estimated total medical costs from workers' comp rose from 12.1 percent in injury-year 1998 to 13.4 percent in 2003, with the most recent year "potentially signaling the beginning of a slowdown," NCCI said.
The study found that six of the 10 states that researchers examined (California, Colorado, Florida, Illinois, Kentucky, Massachusetts, North Carolina, Oregon, Tennessee and Texas) have prescription-drug-to-medical-costs ratios close to the overall 2003 average of 13.4 percent, while Florida and Kentucky have somewhat higher ratios, and Illinois and Oregon have somewhat lower ratios.
NCCI said that average price-per-unit for a given drug is usually higher in Illinois, but less expensive drugs, particularly generics, are a greater percentage of all prescriptions in Illinois and so price-per-unit is lower than Florida.
In Florida, the report noted, the Oxycontin painkiller–a relatively expensive drug–is prescribed more often than all other drugs.
The report said that the percentage of times a generic drug was prescribed when available in 2003 rose to 89 percent, compared to 86 percent in 2002.
Anti-inflammatory and painkillers remained the top drug group, representing 52 percent of total prescription drugs paid for in 2003, the report said.
The study listed prescribed drugs by total paid in workers' comp in 2003. The top ten in order were:
o Celebrex (anti-inflammatory).
o Hydrocodone/Acetaminophen (painkiller).
o Carisoprodol (muscle relaxer).
o Oxycontin (painkiller).
o Neurontin (painkiller).
o Vioxx (anti-inflammatory).
o Ranitidine (HCL H2 blocker).
o Bextra (anti-inflammatory).
o Naproxen (anti-inflammatory).
o Duragesic (painkiller).
The report is being published online at www.ncci.com.
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