WCRI Session – Off-Label Prescribing and the Effects of Opioid-Related Policies
WCRI Session Speakers: Vennela Thumula, PhD, Bogdan Savych, PhD
The data from this WCRI (Workers Comp Research Institute) session yesterday provided indications of shocking increases in topicals. The session also pointed out that the effects of state opioid-related policies were negligible.
Topicals are anything that is applied to the skin such as patches, creams, and gels. If one looks at the chart above for diclofenac, the use is also spiking for the overall market.
South Carolina led the way with 40% of prescriptions having a dermatological component.
Some of the numbers from this session were:
- 21% of prescriptions – 2015 – were opioids
- 202o – the percentage of opioid prescriptions were reduced to 8% of prescriptions
- 11% of prescriptions in 2015
- 21% – that seems to be a rather large number for topicals
I was not expecting the percentage to be that high.
The two top topicals that were responsible for the topical prescriptions were Diclofenac and Lidocaine. Approximately 91% of the topical prescriptions written were Diclofenac and Lidocaine.
What is Diclofenac topical?
-next two sections not part of the presentation
According to Drugs.com, Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID).
Diclofenac topical (for the skin) is used to treat joint pain caused by osteoarthritis. diclofenac topical is for use on the hands, wrists, elbows, knees, ankles, or feet. Diclofenac topical may not be effective in treating arthritis pain elsewhere in the body.
What is lidocaine topical?
Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.
Lidocaine topical (for use on the skin) is used to reduce pain or discomfort caused by skin irritations such as sunburn, insect bites, poison ivy, poison oak, poison sumac, and minor cuts, scratches, or burns. Lidocaine topical is also used to treat rectal discomfort caused by hemorrhoids.
Lidocaine topical may also be used for purposes not listed in this medication guide.
DE and SC have the highest use of topicals. I would have to agree with this statement when analyzing claim payments.
The physicians in FL, GA, IL, MD, DE, SC, and VA supplied 20 – 30% of the topical medications in 2020.
WCRI Session Best Question
What have states done to control the spike in topical prescription medications? A few of the states have included topical prescriptions in their drug formularies. OH, NY and KY have included them recently.
This WCRI session provided a great insight into what is now becoming a problem with Workers Comp treatment. This was a great session with excellent presenters.