Workers' Comp

Enlyte Drug Trends Report Indicates Significant Drop of Opioid Use in Comp

April 30, 2024

Overall opioid utilization down nearly 10%; sustained-release opioids drop by over 10%

SAN DIEGO – April 30, 2024 – Efforts by workers’ comp regulators and professionals to control opioid prescriptions and distribution are resulting in one of the largest drops in utilization the workers’ comp industry has seen in years, according to researchers who published part one of Enlyte’s 2024 Annual Pharmacy Solutions Drug Trends Report today.

Each year Enlyte researchers analyze drug utilization and spending trends in workers’ comp to provide the industry with new insights in pharmacy management. Enlyte’s 2024 series reflects on trends clients experienced in 2023, with an overview of both in- and out-of-network prescriptions. 

Among opioid categories, the report indicates decreases in utilization, including sustained-released opioids, which dropped by more than 10% in 2023, as supported by prescribing guidelines. Enlyte’s data also shows overall opioid usage per claim dropped by nearly 10%, while cost per claim decreased by more than 7%. 

“This, by far, marks one of the largest drops in opioid utilization we’ve seen in years,” said Nikki Wilson, PharmD, MBA, senior director, clinical pharmacy solutions. “In addition, opioid alternatives commonly prescribed to manage acute and chronic pain also experienced decreases in utilization per claim, although to a lesser degree than opioids.”

Researchers also noted per claim drops in overall drug cost and utilization in workers’ comp among therapeutic classes ranked by cost in 2023. Though eight of the top 10 therapeutic classes experienced increased costs per script — with two classes rising by more than 10% — utilization per claim fell in every class except migraine medications, which jumped 17%. 

The largest script cost increases were within the respiratory and migraine medication classes at 14.7% and 10.2%, respectively, and both classes were among the top five therapeutic classes to experience brand average wholesale price increases in 2023, which likely contributed to the rising cost per script, said Wilson.

“Basically, what’s driving these trends are the costs of the top three medications in their respective classes,” she said. “For instance, for migraine medications, Nurtec ODT is prescribed about 15% of the time yet makes up more than 31% of the total drug spend in this category. Similarly, respiratory medication like Trelegy Ellipta is prescribed about 10%, but accounts for nearly 19% of all respiratory medication total costs.” 

Additionally, Enlyte data shows that retail and mail order prescriptions are trending downward with utilization per claim falling by more than 5% and cost per claim down by 0.2%. However, costs per script continue to rise, increasing from last year’s report by 5.2%. 

To access part 1 of Enlyte’s drug trends report, click here.

About Enlyte
Headquartered in San Diego, CA, Enlyte ( is the parent company of Mitchell, Genex and Coventry, leaders in cost-containment technology, independent medical exams (IME), provider and specialty networks, case management services, pharmacy benefit and disability management. The Enlyte businesses align their joint industry expertise and advanced technology solutions in a combined organization of nearly 6,000 associates committed to simplifying and optimizing property, casualty and disability claims processes and services.