Trend for Express Scripts Workers’ Compensation clients from 2012 to 2013 was 9.5%, affected heavily by an 8.2% increase in the average cost per prescription. Utilization, at 1.1%, increased only slightly. The increase in the cost per prescription of both compounded medications and non-narcotic medications used to address pain contributed to the higher trend. The largest increase occurred in compounded medications, also often used in pain management, whose average cost per prescription increased 29.8%. Although the use of non-narcotic medications – primarily nonsteroidal anti-inflammatory drugs (NSAIDs) and antidepressants – as alternatives to narcotics in pain management may generally be viewed as positive, increases in the cost per prescription of NSAIDs (19.4%) and antidepressants (10.6%) had a significant impact on pharmacy trend. By contrast, new drugs accounted for only 0.2% of the trend in 2013.
This report, the eighth in the series, examines what drove pharmaceutical trend for Workers' Compensation clients in 2013.
- Overall spend for narcotic analgesics, the most expensive therapy class, remained flat at $512.93 per user per year in 2013.
- For the first time, compounded products made the top 10 therapy classes, ranked by 2013 per-user-per-year cost; this therapy class increased 125.6% from 2012 to 2013. The average cost of compounds per prescription in 2013 was $1,299.13.
- Overall spend for anticonvulsants, which may also be used for treating neuropathic pain, increased 13.0%.
- Spend for NSAID medications, used in treating pain and inflammation, increased 21.1% to reach $146.05 per user per year.