A new study shows that nonsteroidal anti-inflammatories (NSAIDs) now account for more than one-third of all drugs dispensed to injured workers in California, triple the proportion for opioids.

A study from the California Workers’ Compensation Institute released on Wednesday also shows that although most NSAIDs that are used are inexpensive, and utilization has been flat since the state’s evidence-based prescription drug formulary took effect in 2018, NSAIDs’ share of the total drug spend has soared from 14.2% to 23.5%.

The surge was largely driven by increased payments for two low-volume, high-priced drugs that are exempt from prospective utilization review and that lack price controls, according to the CWCI study.

The CWCI examined the distribution of California workers’ compensation prescriptions and prescription payments over the past decade using data on 5.85 million prescriptions dispensed to injured workers, resulting in payments totaling $623 million.

The CWCI data shows opioids accounted for 11.6% of the prescriptions filled in the first half of 2020, down from 31.0% in 2011 – a decline of 62.6% during the study period.

NSAIDs, often considered non-opioid alternatives to treat pain, surpassed opioids as the number one drug group in 2015, and in both 2019 and the first half of 2020 they accounted for more than one-third of all prescriptions dispensed to injured workers, twice the proportion noted a decade earlier, according to the CWCI.

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