Migraine meds on rise in comp despite overall drop in scripts

Migraine medications and topicals are gaining ground as alternatives to pain management for injured workers, according to a drug report released Wednesday by Enlyte LLC.

Yet opioids continue to be the most-prescribed drug class in workers compensation, even as such prescribing declined by 7.8% in 2024, in line with a years-long trend. Other top drugs prescribed most frequently include nonsteroidal anti-inflammatory drugs, anticonvulsants, muscle relaxants, and topicals.

The number of migraine medications and topical utilization prescribed per claim increased by 8.7% and 1.8%, respectively.

Insurers and employers are spending less on the top therapeutic drug classes in comp, yet the largest script cost increases were driven in part by increases in brand average wholesale pricing, jumping 3.2% for topicals and 2.9% for migraine medications.

The researchers also noted a significant relationship in duration of claims and drug utilization/costs in workers comp. Enlyte’s data showed that claims open for more than two years account for 92.1% of the total drug spend, while those open less than one year account for less than 8%.