Opioids continue to decline, topicals climb among injured workers: report

While opioid prescribing continues to decline for those treating injured workers, more expensive topical medications continue to surge, according to a drug trends analysis released Wednesday by Enlyte.

According to the data from 2024 claim activity, the percentage of injured employees using opioids decreased to 20.1%, and high-dose opioid prescriptions fell by 10.2%.

Despite the drops in opioids, among the most common drugs prescribed to injured workers, the data showed overall prescription cost per claim increased 4.3%. According to Enlyte, this growth was driven “primarily by high-cost topical agents predominantly obtained through out-of-network channels, increased utilization and spending in migraine medications, and rising average wholesale prices for certain brand medications.”

Topical medications, while representing only 13.9% of out-of-network prescriptions, account for a disproportionate 40.2% of out-of-network spending. Enlyte classified this as “opportunistic products,” which include private-label topical analgesics and other “cost-inflated products,” representing just 3.9% of prescription volume but accounting for 20.5% of total costs.

Generic drug utilization reached 88.9%, up .9 percentage points from the previous year, and average wholesale price inflation moderated to 1.5%, down from 4.4% in 2023, “suggesting some stabilization in underlying drug pricing pressures,” the analysis says.