Dermatological Drugs Dominate California Workers’ Compensation Spending
Dermatological Drugs Dominate California Workers’ Compensation Spending
Dermatological drugs, including several high-priced, private-label medications, now account for the largest share of drug spending in California’s workers’ compensation system, according to a new report from the California Workers’ Compensation Institute (CWCI).
CWCI’s latest analysis highlights recent trends in drug prescriptions for injured workers in the state, revealing significant shifts in both drug utilization and payment distribution. While anti-inflammatory medications lead in the number of prescriptions, dermatologicals have surpassed all other categories in total spending.
Trends in Drug Prescriptions and Spending
CWCI’s Prescription Drug Interactive Application ranks the top 10 therapeutic drug groups in California workers’ compensation by prescription volume and total reimbursements. Comparing data from 2016 through June 2024, analysts observed:
Anti-inflammatory drugs: These surpassed opioids in 2016 as the most prescribed drug group and by 2021 made up 35.3% of all prescriptions.
Ibuprofen accounted for much of this growth, increasing from 32.9% of anti-inflammatory prescriptions in 2017 to 42.2% in 2021, where it stabilized.
In 2023, ibuprofen remained the most commonly prescribed drug, making up 14.1% of all prescriptions, followed by naproxen at 8.2%.
Declining opioid us: Opioids’ share of prescriptions dropped significantly, from 30.8% in 2010 to just 7.9% in 2023. This decline aligns with California’s adoption of the Opioid and Pain Management Guidelines in 2017 and the implementation of the MTUS Formulary in 2018.
Rising dermatologicals: Dermatological drugs, often used for pain management, grew from 4.9% of prescriptions in 2016 to 12.6% by mid-2024.
Much of this increase was driven by lidocaine and diclofenac sodium, which rose from 46% of dermatological prescriptions in 2016 to 81.6% in 2024.
Spending on Dermatologicals
Dermatologicals have also seen a sharp rise in spending. In the first half of 2024, lidocaine (average payment $159 per prescription) became the top drug by total spending in California workers’ compensation, representing 8.5% of all drug payments. This was more than double the spending on naproxen (4.2%) and anticonvulsant pregabalin (4.1%).
Conclusion
These trends demonstrate a clear shift in California workers’ compensation drug prescriptions and spending. Anti-inflammatory drugs remain the most prescribed, while dermatological medications now dominate in terms of costs, reflecting evolving treatment practices and regulatory changes.
For additional insights, CWCI members and research subscribers can access the full report and top therapeutic drug group rankings under the Communications tab on the CWCI website.