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Hillbillies can breathe a little easier. OxyContin, the pharmaceutical painkiller known as "hillbilly heroin" to law enforcement officials because of its popularity as an illegal recreational narcotic for some residents of the Appalachians, is no longer the most costly drug used in workers' compensation cases, according to a new study.

The annual Hartford Financial Services Group Inc. study of the 25 most costly drugs in workers' compensation revealed that Lidoderm, a non-narcotic painkiller delivered with a patch, is now the most expensive drug used in workers' compensation.

With the cost of pharmacy prescriptions making up such a large part of total workers' compensation costs, The Hartford's researchers said they "remain concerned" about the frequent use of narcotics to managenonmalignant pain in injured workers.

"Narcotics amount to 40 percent of the workers' compensation claim dollars we spend on pharmaceuticals," said Dr. Robert Bonner, medical director for The Hartford.

Steep increases in the per-dose costs of some heavily prescribed drugs also remain a concern. Actiq, a painkiller that contains the synthetic opioid Fentanyl, rose 70 percent in price in 2006 from the previous year, according to The Hartford researchers. The researchers classified Actiq as the most expensive drug used in legal treatment of injured workers. The antidepressant Tofranil-PM rose some 74 percent in price in 2006 compared with 2005, they said.

Over the past two years, The Hartford determined that workers' comp pharmacy costs, when taken as a whole, have been relatively flat. Costs dropped 1 percent overall in 2005 and rose by 3 percent in 2006.

February 14, 2008

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