A Decade of Declining Utilization, Shifting Drug Mix, and Emerging Cost Pressures:
The Prescription Drug Trends report examines workers’ compensation prescription drug usage and payment patterns in Pennsylvania from 2012 through 2022. Drawing on data from the Pennsylvania Medical Data Call, the report analyzes changes in utilization, pricing, and total drug costs, with a particular focus on opioids, generics, and topical agents. The findings provide employers, insurers, and policymakers with objective insight into how prescribing practices and regulatory reforms have reshaped prescription drug costs within the workers’ compensation system.
9%
Prescription drug payments’ share of total medical payments, down from a peak in 2014, reflecting sustained reductions in utilization despite rising costs in specific drug categories.
What’s in the report
- Opioid use has materially decreased. Claims involving at least one opioid prescription dropped from roughly 1 in 6 claims in 2012 to about 1 in 20 claims by 2022, reflecting policy reforms and changing clinical practices.
- Generics now dominate prescription volume. The expiration of patents for several high-volume drugs accelerated the shift from brand to generic prescribing, contributing to lower overall drug costs.
- Topical drugs are an emerging cost driver. While utilization remains comparatively limited, payments for topical agents doubled over the study period, driven by higher per-unit prices and increasing adoption.