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Important studies

Prescription drug utilization driving WC costs

A recent NCCI Holdings Inc. study shows that the volume of prescription drugs dispensed to Worker's Compensation claimants has risen sharply—putting upward pressure on costs. After two seemingly abnormal years in which price change was the dominant factor affecting per-claim WC Rx cost increases, utilization change has once again taken its historically dominant role. OXYCONTIN® has become the top prescribed (in terms of paid dollars) WC Rx. A successful patent defense, which resulted in the removal of the extended release generic version of OXYCONTIN® from the market, is likely the major contributing factor.

Over prescribing pain killers, an acute problem in Workers' Comp

According to a study by the California Workers' Compensation Institute, just 3% of doctors who treat Workers' Compensation patients in California are responsible for writing more than half the prescriptions for the most potent and addictive pain medications. Those doctors ordered such drugs as morphine and oxycodone in higher doses than other workers' comp doctors and prescribed the medications for minor back pain or other conditions that may not have required such strong treatment, driving $2 out of every $3 spent for these drugs.

The recovery period for injured workers taking the highest level of pain medications averages 119% longer than patients receiving no narcotics or very low doses of those drugs, according to the study by the institute and can create a secondary medical problem, addiction.

According to an article in the San Francisco Chronicle, Most Prescriptions from 3% of Workers' Comp Doctors, health experts say that overprescribing these drugs is a particularly acute problem in Workers' Compensation. The article quotes Joe Paduda, a principal with Health Strategy Associates, "The workers' comp industry is a very soft target for health care providers and other people who want to take advantage of regulatory or other loopholes."

The industry is more loosely regulated than standard health insurance, and the system lacks such controls as co-payments and deductibles to rein in costs, Paduda said. He said employers, public agencies and other payers can be reluctant to question prescribing patterns because of the litigious nature of Workers' Comp.

The report, "Prescribing Patterns of Schedule II Opioids in California Workers' Compensation," can be found at

Recession increases duration of temporary total disability (TTD)

The mean duration of TTD indemnity benefits went from approximately 123 days for injuries that occurred in 2006 to a projected 141 days for injuries that occurred in 2009. At the same time, unemployment rose from 4.6% to 8.7% nationally.

While the study found duration varies significantly by state, most follow the pattern of increasing duration in the most recent one to three years. According to NCCI's Director, John Robertson, "The bottom line is that the recession does seem to have at least correlated to an increase in TTD in just about every state. We think that's associated largely with a lack of return-to-work opportunities, or at least greatly reduced RTW opportunities in many companies."

Alcohol more lethal than heroin, cocaine

British experts evaluated substances including alcohol, cocaine, heroin, ecstasy and marijuana, ranking them based on how destructive they are to the individual who takes them and to society as a whole.

Researchers analyzed how addictive a drug is, how it harms the human body, its social and economic costs such as social services, health care and prison, as well as environmental damage caused by the drug.

Heroin, crack cocaine and methamphetamine, or crystal meth, were the most lethal to individuals. When considering their wider social effects, alcohol, heroin and crack cocaine were the deadliest. But overall, alcohol outranked all other substances, followed by heroin and crack cocaine. Marijuana, ecstasy and LSD scored far lower.

The study was paid for by Britain's Centre for Crime and Justice Studies and was published in the medical journal, Lancet. Alcohol's high use and devastating consequences, not only for drinkers but also for those around them resulted in the high score.

Many workers feel stressed, undervalued: survey

Many workers feel stressed out, undervalued and dissatisfied with their job, according to a survey released March 8 by the American Psychological Association.

Low salary was cited by more than half as having a significant impact on their stress levels; other factors commonly cited included lack of opportunities for advancement (43%), heavy workload (43%), unrealistic job expectations (40%) and long hours (39%).

Slightly more than one-half of workers reported feeling valued on the job, while nearly one-third reported they intend to seek employment elsewhere in the coming year.