Dermatologicals top workers comp drug costs: study

Dermatological agents accounted for the largest share of workers compensation prescription payments in early 2025, with much of the spending concentrated in delivery pharmacies and physician dispensing channels, according to a report released Thursday by the Workers Compensation Research Institute.

The Waltham, Massachusetts-based institute said physician dispensing and delivery pharmacies accounted for more than 70% of dermatological prescription payments in 20 of 31 study states during the first quarter of 2025. In states with the highest dermatological payment shares, those channels accounted for roughly 80% to 95% of dermatological payments.

The report found that dermatological agents and nonsteroidal anti-inflammatory drugs remained the largest prescription cost drivers. Dermatological agents accounted for 23% of prescription payments in the median state and more than 30% in 12 states. NSAIDs accounted for 15% in the median state.

Overall prescription drug payments also rose in most states after several years of declines. Quarterly prescription payments per medical claim increased 24% in the median state between the first quarter of 2022 and the first quarter of 2025, rising to $63 from $51.

The report found wide interstate variation. Prescription payments per medical claim fell 22% in Minnesota but rose 34% in Florida and 36% in Pennsylvania. As of the first quarter of 2025, payments ranged from about $14 per medical claim in Minnesota to $353 in Louisiana.

WCRI also found that migraine drugs are emerging as a growing cost component, while opioid payments continued to decline in nearly all states, though less sharply than in prior years.