Lipoderm Jumps to Top of Most Expensive Drug List

According to a press release from The Hartford Financial Services Group, Inc., OxyContin, the long-acting narcotic painkiller that headed the list each year since 2001, had dropped to number five, replaced by Lidoderm, a non-narcotic pain killer in patch form, according to the 2006 annual study of the 25 most costly drugs in workers’ compensation.

“We remain concerned about the widespread use of narcotic pain killers to manage non-malignant pain in injured workers,” said Dr. Robert Bonner, MD, MPH and medical director for The Hartford, in a press release. “Narcotics account for 40 percent of the workers’ compensation claim dollars we spend on pharmaceuticals, but other pain management drugs and combinations would work equally well for some patients and avoid the potential risks associated with narcotics.”

Still, considering OxyContin’s continued popularity in the face of years of publicity about patients becoming addicted or selling the drug, it is unclear as to how the use of this drug will trend over the next few years, according to the release.

Trend Impacts

One reason The Hartford publishes its annual study is to track expenditure over time as they impact trends. The Hartford found workers’ compensation pharmacy costs relatively flat for the past two years, rising just three percent in 2006 after dropping by one percent in 2005. Bonner credits his team’s careful and aggressive pharmacy oversight.

Ensuring that the correct reimbursement is made remains a challenge in the face of steep per-prescription increases, according to the report. The average per-dose price of Actiq (#7), already the most expensive drug used for workers’ compensation patients, rose 70%, and the anti-depressant Tofranil-PM (#146), rose by 74%.

A complete list of The Hartford’s Top 25 Drugs in Workers’ Compensation is reproduced on the next page.

The list below, which shows ranking by total paid for the medication for 2004, 2005 and 2006, as well as year by year paid-per-prescription increases or decreases for each drug, is based on aggregated worker's compensation claim data from The Hartford.