Generally, prescription drug costs account for approximately 14% of a workers’ compensation claim. While prescription drug usage has decreased in recent years, the prices of prescription drugs continue to rise. The number of opioid prescriptions continue to decrease as physicians opt for alternative treatments for work injuries. There are several negative trends becoming more prevalent that could increase workers’ compensation claim costs. Specialty medication usage and pricing continues to increase for injured workers. Older worker injury claims tend to cost more due to the increase in prescription drug pricing. Lastly, despite the decrease in opioid usage, injured workers are still too often prescribed unnecessary prescription drugs which can lead to dangerous health conditions and increased complexity of workers’ compensation claims.

Prescription Drugs

The increasing use of prescription medications places unique challenges on workers’ compensation programs. A 2020 report by the National Council on Compensation Insurance (NCCI) determined that prescription drugs account for approximately 14% of a workers’ compensation claim. The report reveals that the price of drugs continue to rise but the overall usage is decreasing. There are several factors leading to this trend. First, drug costs per claim have gone down due to lower utilization by injured workers. Second, prescription drug prices continue to rise, although at a slower rate than in recent years. Third, the number of opioid prescriptions continue to decrease as physicians seek out and opt for alternative pain control treatments.

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