The Hartford's Annual Study Finds Cost of Drugs in Workers' Compensation Rising at a Lower Rate in 2004, But Newer, Expensive Dr
18 Avril 2005 - 10:30PM
PR Newswire (US)
The Hartford's Annual Study Finds Cost of Drugs in Workers'
Compensation Rising at a Lower Rate in 2004, But Newer, Expensive
Drugs Continue to Push Up Costs Increased notoriety fails to quell
use of Actiq or Neurontin, study shows HARTFORD, Conn., April 18
/PRNewswire-FirstCall/ -- The rate of pharmacy inflation in
workers' compensation is moderating for the second straight year,
with costs rising by 6 percent in 2004, down from 13 percent in
2003, according to a study by The Hartford Financial Services
Group, Inc. (NYSE: HIG). Speaking at a press conference at the Risk
& Insurance Management Society (RIMS) conference in
Philadelphia today, Robert E. Bonner, MD, MPH, The Hartford's
medical director, attributed the improvement to careful pharmacy
management, including an extensive review process. Nevertheless,
the newly released list of the top 25 drugs prescribed for workers'
compensation in 2004, continued to indicate that off-label drug use
contributes to rising pharmaceutical costs, Dr. Bonner noted.
Off-label drug use is defined as the use of prescription drugs in
ways not approved by the U.S. Food and Drug Administration (FDA).
Dr. Bonner also noted that despite widespread negative publicity in
2004, several drugs, such as Actiq and Neurontin, continued to be
widely used for workers' compensation patients. "Actiq is a
powerful painkiller approved by the FDA for cancer patients with
breakthrough pain, but it jumped to number nine from 15 in 2003,"
said Dr. Bonner. "The drug is a narcotic that comes in a lollipop
or lozenge form and takes just a few minutes to enter the
bloodstream. The FDA is concerned about its potential for diversion
and abuse. Actiq's climb up the chart suggests it is being used for
a much wider group of patients than those the FDA originally
intended." Similarly, the drug Neurontin held steady at number two
on the list, despite its owner paying more than $430 million to
settle state and federal charges relating to the drug's promotion
and marketing to physicians. The FDA approved the drug in 1999 to
treat seizures in epilepsy, then approved it in 2002 to treat pain
following shingles outbreaks (post-herpetic neuralgia). Even so,
the percentage of patients for workers' compensation injuries being
treated for either condition is dramatically smaller than the usage
of the drug suggests. Meanwhile, Oxycontin, a strong painkiller
that gained notoriety several years ago from reports of its
popularity for abuse and drug trafficking, continued to top the
list for the third year in a row. In 2004, the actual number of
claims in which Oxycontin has been prescribed declined by 25
percent. "Drugs to control pain dominate the Top 25 list, and that
certainly makes sense for treating many of the injuries workers'
sustain on the job, said Dr. Bonner. "Still I worry that a 'newer
is better' philosophy may put patients on stronger, riskier drugs
when more established medications often have lower risk and cost."
COX-2 inhibitors like Celebrex (number three on the list), Vioxx
(number seven on the list despite being withdrawn from the market
nine months into 2004) and Bextra (number six on the list) were
frequently used in place of drugs such as Aspirin and Ibuprofen.
Those and other non-steroidal anti- inflammatory drugs may be just
as effective as their expensive brand name counterparts. The FDA's
recalls and warnings of the newer drugs suggests more changes to
come, and early indications in 2005 data show a continued decrease
in prescribing patterns for these drugs. While pharmacy costs have
doubled as a percentage of workers' costs over the past five years
and while injured workers are receiving more drugs and more
expensive drugs, data suggests the trend may be abating. The Top 25
list represents 61 percent of all prescription medicine prescribed
for workers' compensation, up from 58 percent in 2003. The majority
of drugs on the list of the top 25 are painkillers such as
Oxycontin, Oxycodone and Duragesic. The list also includes
antidepressants such as Zoloft, sleeping pills such as Ambien and
muscle relaxers such as Skelaxin. Although costs for prescription
drugs continue to rise, The Hartford's pharmaceutical inflation
rate is about half that of many workers' compensation insurers. As
part of its continuing efforts to manage pharmaceutical costs, The
Hartford uses an extensive review process that looks at the drugs
that injured workers are taking to determine if they are related to
the worker's specific injury. The process also checks for errors in
which prescriptions unrelated to a worker's injury are erroneously
processed at the pharmacy as workers' compensation prescriptions.
Dr. Bonner said that The Hartford and its Specialty Risk Services
(SRS) third-party claims administrator together have saved more
than $13 million in pharmaceutical costs for clients during the
past year through careful monitoring, negotiated prices and other
controls. The Hartford is one of the nation's largest financial
services and insurance companies, with 2004 revenues of $22.7
billion. The company is a leading provider of investment products,
life insurance and group benefits; automobile and homeowners
products; and business property-casualty insurance. The Hartford's
Internet address is http://www.thehartford.com/. Some of the
statements in this release may be considered forward-looking
statements as defined in the Private Securities Litigation Reform
Act of 1995. We caution investors that these forward-looking
statements are not guarantees of future performance, and actual
results may differ materially. Investors should consider the
important risks and uncertainties that may cause actual results to
differ. These important risks and uncertainties include those
discussed in our Quarterly Reports on Form 10-Q, our 2004 Annual
Report on Form 10-K and the other filings we make with the
Securities and Exchange Commission. We assume no obligation to
update this release, which speaks as of the date issued.
Contact(s): Sue Honeyman Victoria Gallant 860-547-4976 860-547-4938
The Hartford's Top 25 Drugs in 2004 Workers' Compensation (Ranked
by Total $ Costs) Rank Cost Increase* Drug Name 2004 2003 2002
2004v2003 2003v2002 Oxycontin 1 1 1 2% 15% Neurontin 2 2 3 15% 12%
Celebrex 3 3 2 2% 12% Hydrocodone 4 4 5 -2% 2% Duragesic 5 6 6 12%
14% Bextra 6 7 11 4% 33% Vioxx 7 5 4 1% 6% Lidoderm 8 11 22 9% 12%
Actiq 9 15 32 15% 55% Skelaxin 10 10 13 30% 29% Ambien 11 9 9 9%
14% Carisoprodol 12 8 7 -12% 8% Tizanidine 13 12 37 -1% 60%
Ultracet 14 16 19 6% 23% Effexor 15 20 17 11% 13% Tramadol Hcl 16
14 35 -5% 30% Oxycodone 17 NR NR 131% NR Cyclobenzapr 18 13 12 1%
11% Topamax 19 22 24 8% 22% Naproxen 20 21 16 -7% 17% Morphine Sul
21 23 29 -11% -1% Zoloft 22 24 18 2% 6% Propo-N/Apap 23 19 14 -7%
-3% Mobic 24 NR NR 9% NR Endocet 25 NR NR 46% NR All Pharmacy 6%
13% * Change in the average prescription cost in the calendar year
for claimants receiving the drug. NR -- Not ranked in the top 25 in
the year identified DATASOURCE: The Hartford Financial Services
Group, Inc. CONTACT: Sue Honeyman, +1-860-547-4976, , or Victoria
Gallant, +1-860-547-4938, , both of The Hartford Web site:
http://www.thehartford.com/
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