Part Two: Evaluating In-Network and Out-of-Network Trends As part of our ongoing drug trends series, in part two of our analysis we’re taking a closer look at the top therapeutic classes by age of claim. Stay tuned for more posts addressing specific trends highlighted in the series. Today we are going to take a deeper dive into Coventry’s Drug Trends by focusing on the influence of claim age as it relates to overall use of prescription drug classes. The data covered here reflects all mail order and retail transactions paid in 2019. When we look at the younger claims (claims less than 2 years of age) Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, steroids, anti-infectives, and non-opioid analgesics are used much more often for the treatment of injuries during the early stages of a claim. The most utilized class remained NSAIDs (i.e. ibuprofen, naproxen or meloxicam) followed by muscle relaxants and short-acting opioids. Notably, the share of short-acting opioids (think morphine, hydrocodone, or oxycodone products) continued to decrease year-over-year coupled with an increase in other 1st-line treatments and are now #3 compared to last year when they were #2 for this age group. These alternative classes that can be used for pain are typically utilized more commonly in younger claims when compared to those claims 2 years or older. Younger claims also utilize more anti-infective agents or steroids which is not surprising considering the types of fills that may fall into the 2 year or less category. Injuries that result in open wounds or broken skin are often treated with antibiotics to prevent infection and it is not unusual to see a one-time fill for these types of medications along with, depending on the severity of the injury, a shorter claim life with closure once the wound resolves. Along the same lines, steroids such as prednisone or dexamethasone are often used to reduce inflammation in respiratory injuries or in musculoskeletal injuries early on (although they can be used later or even years later if there is an injury aggravation). Now let's contrast some of what we have just reviewed for younger claims with the top therapeutic class trends for claims age 2 years and older. Again, there is a positive trend of increased use of opioid alternatives that can often be used for pain management. This follows evidence-based treatment recommendations and mirrors the Food and Drug Administration (FDA) guidelines for limiting the use of extended-release opioids. The biggest difference in the age of a claim is seen in anti-convulsants. These medications were originally on the market for treating and preventing seizures but have shown good evidence in managing pain that is commonly seen in older claims. Namely, chronic pain or neuropathic pain. Additionally, anti-depressants are much more likely to be used in older claims because work related injuries can often cause disruptions to one’s income, home life, or hobbies that tend to build over time and if an injury causes chronic pain, the risk for depression is further worsened. Overall claims with greater medical severity tend to remain open longer than claims that fall within the 2 year or less bracket. Moreover, in these older claims a number of different medications are commonly trialed over the course of 2+ years to find the best treatment option for these patients while trying to lessen negative outcomes. Looking at each claim age bracket and understanding the different claim populations and the types of drug treatments associated can highlight the importance of early and ongoing-targeted intervention, which can ultimately help us to improve return-to-work and make the most of opportunities for impact.
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2020 Year in Review
We can all agree that 2020 was a year filled with uncertainty, anxiety, and change. Despite the challenges, here at the Coventry we stayed focused on our clients and injured workers and continued to provide the quality content our readers have come to rely on. We are grateful to our followers and would like to extend a huge thank you to everyone who read, shared, and promoted The Sounding Board blog during our inaugural year. We aim to bring useful topics and insights on the issues affecting the work comp industry.
WCRI 37th Annual Workers’ Comp Issues and Research Virtual Conference
The WCRI Annual Issues and
FDA Authorizes Second Coronavirus (SARS-CoV2) Vaccine for Use
The vaccine produced by Moderna has been granted emergency use authorization for distribution in the United States.
Network 2.0 - Constructive partnerships between providers and payers
In our last blog post we discussed how networks help to manage the relationship with the provider and allow patients to sidest
Mitchell Predicts 2021 Trends in Its Fourth Quarter 2020 Industry Trends Report
According to Mitchell experts, 2021 will see growth in personal vehicle ownership and electric vehicles, rising accident severity and increasing automation and digitization in the claims process.
Current Used Vehicle Market Conditions: Q3 2020
September 2020 Kontos Kommentary The following commentary is produced monthly by Tom Kontos, Chief Economist, KAR Global. KAR Global is a leading provider of wholesale used vehicle auctions and ancillary remarketing services.1