The Hartford Publishes Annual List of Top Drugs Used in Workers’ Compensation Claims
HARTFORD, Conn., Aug. 17 /PRNewswire-FirstCall/ — Time has been credited with healing all wounds. Now, according to a study by The Hartford Financial Services Group, Inc. , one of the nation’s leading providers of workers’ compensation insurance, time may also help to curb the rising cost of drugs used to treat workers’ compensation cases.
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In its most recent annual survey of the Top 25 Drugs in Workers’ Compensation, The Hartford found that overall pharmaceutical costs for its workers’ compensation clients actually decreased during 2005. This dip, based on the company’s research data, is linked in part to the greater availability of generic substitutes, especially for the most popular and expensive name-brand drugs.
“The emergence and increased use of generic substitutes for OxyContin and Neurontin, two of the more expensive and widely used drugs for treating pain in workers’ compensation cases, is having a significant effect on pharmaceutical costs,” said Dr. Robert Bonner, MD, MPH, and medical director for The Hartford. “In addition, the withdrawal of the popular Cox-2 inhibitors Bextra and Vioxx, which were frequently taken to manage pain and inflammation, is helping to drive down pharmacy costs for patients receiving care under this system.”
While The Hartford had been reporting progressively smaller annual increases since the first study was published in 2001, this past year marked the first time ever that costs actually declined slightly — by about 1 percent.
“Beyond a shift to some key generic drugs, The Hartford’s careful pharmacy management and extensive claims review process also have contributed to this downturn in costs,” said Dr. Bonner. “Still, we shouldn’t presume this decline is the beginning of a trend, especially as more drugs are being prescribed and overall pricing continues to rise.”
Survey Highlights
For example, while use of OxyContin declined, it was more than offset by adoption of its generic version, Oxycodone, which costs less than half the price of the brand-name. In fact, total consumption of this potent pain-killer in original or generic form increased by 6 percent.
Neurontin, last year’s second-highest ranked drug, was pushed to number 20, replaced in the second spot by its generic version, Gabapentin, which wasn’t even on the list in 2004. Gabapentin is priced approximately 35 percent lower than Neurontin. Still, over the course of just one year, The Hartford observed a 25 percent price per-pill increase for both versions of this medicine.
Since the first study five years ago, The Hartford’s annual list of top drugs has included many of the most expensive brand-names. But the list also contains some moderately priced drugs due to the high frequency with which they are prescribed.
For example, the inexpensive synthetic narcotic painkiller, Hydrocodone, is similar to OxyContin and Oxycodone, and has been the most frequently prescribed drug for workers’ compensation patients since 2001. Hydrocodone has also been among the top five drugs in terms of total cost, this year rising to third on The Hartford’s Top 25 list.
Use of the inexpensive painkiller, Tramadol, also increased by more than 50 percent and has become the second most prescribed drug on the list. That increase moved Tramadol up from 17 to 12 in terms of dollars spent.
The third most frequently prescribed drug is Ibuprofen, the generic non-narcotic painkiller. Usage was up 26 percent, most likely because it has filled a void left by the U.S. Food and Drug Administration’s (FDA) withdrawal of the Cox-2 inhibitors Vioxx and Bextra in late 2004. As one of the least expensive drugs used in workers’ compensation, though, Ibuprofen ranked only 36 in overall cost and did not make the Top 25 list.
Despite years of negative publicity and fewer prescriptions in 2005, the highly addictive ‘lollypop’ pain killer Actiq continued to rise on the list, moving to number 6 from 9 due to an increase in dosage per-patient and cost per-pill.
“While it’s encouraging to see a flattening out in the number of patients receiving Actiq, this fast-acting narcotic remains a concern because of its high potential for abuse and diversion from the patient,” added Dr. Bonner. “The powerful painkiller was approved by the FDA to treat breakthrough pain in Cancer patients, but its prevalence among workers’ compensation patients still indicates that it’s being prescribed for other pain, as well. We hope this trend reverses itself and more physicians consider other pain-management options.”
A complete list of The Hartford’s Top 25 Drugs in Workers’ Compensation accompanies this news release. The list, which shows ranking by total costs for 2003, 2004 and 2005, as well as year by year cost increases or decreases for each drug, is based on aggregated worker’s compensation claim data from The Hartford.
The Hartford, a Fortune 100 company, is one of the nation’s largest financial services and insurance companies, with 2005 revenues of $27.1 billion. The Hartford is a leading provider of investment products, life insurance and group benefits; automobile and homeowners products; and business property and casualty insurance. International operations are located in Japan, Brazil and the United Kingdom. The Hartford’s Internet address is http://www.thehartford.com/.
Some of the statements in this release may be considered forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995. We caution investors that these forward-looking statements are not guarantees of future performance, and actual results may differ materially. Investors should consider the important risks and uncertainties that may cause actual results to differ. These important risks and uncertainties include, without limitation, those discussed in our Quarterly Reports on Form 10-Q, our 2005 Annual Report on Form 10-K and the other filings we make with the Securities and Exchange Commission. We assume no obligation to update this release, which speaks as of the date issued.
The Hartford’s Top 25 Drugs in 2005 Workers’ Compensation (Ranked by Total $ Costs) Rank Cost Increase* Drug Name 2005 2004 2003 2005v2004 2004v2003 OxyContin 1 1 1 13% 2% Gabapentin 2 NR NR 25% -34% Hydrocodone 3 4 4 -4% -2% Lidoderm 4 8 11 11% 9% Celebrex 5 3 3 0% 2% Actiq 6 9 15 18% 15% Oxycodone 7 17 NR 22% 131% Mobic 8 24 NR 9% 9% Duragesic 9 5 6 10% 12% Ambien 10 11 9 7% 9% Skelaxin 11 10 10 25% 30% Tramadol 12 16 14 -2% -5% Fentanyl 13 NR NR -52% 26% Cyclobenzaprine 14 18 13 -5% 1% Topamax 15 19 22 10% 8% Tizanidine 16 13 12 -5% -1% Carisoprodol 17 12 8 -21% -12% Effexor 18 15 20 -1% 11% Oxyco/Apap 19 NR NR 25% 56% Neurontin 20 2 2 22% 15% Naproxen 21 20 21 -7% -7% Avinza 22 NR NR 11% 34% Propoxyphene 23 23 19 -6% -7% Percocet 24 NR 17 18% 33% Morphine 25 21 23 -15% -11% All Pharmacy -1% 6%
* Change in the average prescription cost in the calendar year for claimants receiving the drug.
NR – Not ranked in the top 25 in the year identified Contact(s): Sue Honeyman 860-547-4976 shoneyman@thehartford.com Debora Raymond 860-547-9613 deborah.raymond@thehartford.com
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The Hartford Financial Services Group, Inc.
CONTACT: Sue Honeyman, 860-547-4976, shoneyman@thehartford.com, orDebora Raymond, 860-547-9613, deborah.raymond@thehartford.com, both of TheHartford Financial Services Group, Inc.
Web site: http://www.thehartford.com/