Workers compensation payers disbursed 3.8% less for prescriptions in 2018, including a 15% drop in opioids, due to a decline in utilization and overall cost per prescription, according to a drug trends report released Thursday by MyMatrixx, a subsidiary of Express Scripts Holding Co.

Overall, 65.9% of comp payers spent less on opioids in 2018, with 17.7% of injured workers reportedly prescribed opioids, down from 21% in 2017, according to the report researchers with the Jacksonville, Florida, pharmacy benefits manager created using pharmacy data from its clients.

The report also revealed details on polypharmacy, highlighting the utilization of combinations of drugs it called “dangerous.” According to the report, 25.8% of injured workers were prescribed an opioid and a muscle relaxant, both depressants; 17.6% were prescribed both an opioid and gabapentin, another central nervous system depressant that experts warn can accelerate the dangerous effects of opioids; 4.8% were prescribed opioids and anti-anxiety benzodiazepines, a combination experts say can slow breathing; and 1.4% percent were prescribed a trifecta of muscle relaxants, opioids and benzodiazepines.

Workers comp payers are also now paying for medicine that can counter an opioid overdose, with four out of 1,000 workers filling a prescription for such prescriptions as Narcan and Evzio.

The report also highlighted that the longer an injured worker takes medicine to treat pain and other conditions, the more expensive the annual costs incurred. For example, comp payers funded on average $212.98 for drugs in the first year of a claim, and after 10 years that figure jumps to $3,936.98, according to the report.

Specialty drugs are also climbing, with comp payers spending 18.5% more in 2018 on drugs that treat rare conditions, according to the report. Drugs to treat human immunodeficiency virus also increased by 19.2% in 2018, according to the report.

Meanwhile, spending for compound medications — many controversial in the comp scheme — decreased 42.3% in 2018, the report revealed.