NSAIDs are taking Opioids as Top Comp Medic in California

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Non-steroidal anti-inflammatory drugs or NSAIDs have replaced opioids as the most common therapeutic drug group prescribed for wounded workers in California, according to a new California Workers & Compensation Institute study.

The study also concludes that payment data show that both dermatological drugs and anticonvulsants now stand for opioids when it comes to total reimbursements.

The study uses data from 5.75 million prescriptions handed out to wounded workers in California from 2009 to June 2018. CWCI analysts investigated changes in prescription and payment payments between therapeutic drug groups, identified trends in the use of generic drugs and certain average amounts that have been paid for medicines within each group drug group in the past decade.

The results show that efforts to counter inappropriate use of opioids continue to have an effect, as opioids fell to 18.0 percent of the prescriptions completed in the first half of 2018, compared to 20.2 percent in 2017 and below 30.5 percent ten years ago.

The credits measure, among other things, stricter control via use assessment and independent medical assessment, limitations on payers, networks of medical service providers, managers of pharmacy payments and in the formulary Medical treatment use schedule.

NSAIDs, often prescribed as non-opioid alternatives to the treatment of pain, outperformed opioids as the most important drug group in California workers & # 39; comp in 2016, and since then their share in recipes has continued to grow to a record level of 31.7 percent of the drugs provided to injured workers in the first half of 2018, according to the CWCI study.

The proportion of anticonvulsants in the prescriptions also increased, more than doubling from 4.1 percent in 2009 to 9.7 percent in the first half of 2018, probably due to their growing use as a non-opioid alternative to treatment neuropathic pain, the study states.

The data from 2018 show that anticonvulsants are the fourth most prescribed drug group to go beyond muscle relaxants, which are not exempted from the use assessment under the MTUS formulary that came into effect on January 1, 2018, with the exception of a limited special filling or perioperative allowances that limit the amount of drug that can be administered.

The study also found shifts in the distribution of prescription payments.

Ten years ago, dermatological products accounted for 10.1 percent of total drug spending in Californian workers, and were the fourth-most expensive drug group behind opioids, NSAIDs and peptic ulcers.

However, in the first half of 2018, that percentage was up to 17.6 percent, making dermatologicals the best drug group in terms of total payments according to the study.

In addition to the rising share of prescribing dollars of employees to dermatologicals, the research also showed that the proportion of anticonvulsants in drug spending tripled from 4.8 percent in 2009 to 15.2 percent in the first half of 2018, so anticonvulsants are now better from opioids as the second most expensive drug group.

The data show that most of the growth of the anticonvulsant share in the payments has occurred over the past four years, coinciding with the decrease in the use of opioids, indicating that some antiepileptics are being used instead of opioids. In particular, anticonvulsant prescriptions used in Californian workers are highly concentrated in just two drugs, one of which is only available as a branded drug and that drug accounted for nearly three-quarters of the anticonvulsant dollars paid in the first half of 2018.

CWCI has published its research in a Research Update report, "California Workers & Comp. Prescription Drug Use and Payment Benefits, 2009-2018: Part 1." The free report can be downloaded from the Research section at www.cwci.org.

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