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Opioid Prescription Likely to Spawn Catastrophic Workers Comp Claims

Posted on: September 7, 2012 by Caitlin Morgan

Opioid Prescription Likely to Spawn Catastrophic Workers Comp Claims

Opioid Prescription Likely to Spawn Catastrophic Workers Comp Claims

A recent report in the Journal of Occupational & Environmental Medicine concluded that when prescriptions for certain opioid painkillers were included in Workers Compensation claims, it was nearly four times more likely that a catastrophic claim would develop.

The report is based on a study that looked at data from more than 12,000 workers company claims processed by Lansing, Michigan-based Accident Fund Holdings throughout January 2006 and February 2010. The study, “The Effect of Opioid Use on Workers’ Compensation Claim Cost in the State of Michigan”, noted that claims involving long-acting opioids were 3.94 times as likely to have a total cost of $100,000 or more compared with claims without any prescriptions. Claims with short-acting opioids were 1.76 times as likely to have a cost of $100,000 or more.

The report also indicted that claims that included long-acting opioids were 9.3 times more costly than claims that did not have such prescriptions, while claims with short-acting opioids were 2.8 times more expensive. According to the study, “to control costs, efforts must be made to rationalize the use of opioids in workers comp claimants, particularly the use of (long-acting) opioids.” The study indicated that injured workers with chronic pain often suffer conditions such as anxiety that can make them more prone to abusing opioid prescriptions.

Injury severity, attorney representation and other factors also contribute to higher medical and indemnity payments, according to the study. Opioid use, however, was an “independent predictor” of whether a comp claim would generate catastrophic costs.

A look at some general stats from NCCI Holdings on opioids and Workers Comp:

NCCI Holdings, which manages the nation’s largest database of Workers Compensation insurance information, estimates that Workers Comp medical costs per claim average more than $6,000 and soar to nearly $25,000 for lost-time claims. In NCCI’s 2011 annual report it’s estimated that prescription drugs accounted for an estimated 19% of these costs in 2009. Some more interesting findings from the NCCI include:

  • The narcotic OxyContin went from the number three Workers Comp drug in 2008 to number one in 2009.
  • The overall increase is driven by utilization, not by the price of the drugs.
  • When a drug is dispensed at the physician’s office rather than at a pharmacy, the cost of the drug is higher.
  • High-cost states are estimated to have an ultimate per-claim Rx cost of more than 1.5 times the median estimate.

MGU Caitlin Morgan has been specializing in the placement of cost workers’ compensation for many years. Give us a call today at 877.226.1027 to help you place your clients’ workers comp program.

Sources: Business Insurance, NCCI Holdings

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Posted in: Workers Comp Workers Compensation