Healthcare Costs Associated with Diagnosed Opioid Abuse

Tampa—The National Survey on Drug Use and Health estimated that 2.1 million Americans ≥12 years of age had prescription pain reliever abuse or dependence in 2012. Prescription opioid abuse leads to significant economic and healthcare costs, estimated at $44.7 billion in 2007.

A recent study by B. Rice and colleagues sought to provide updated estimates on the prevalence and excess healthcare costs of diagnosed opioid abuse. The results of this study were presented at the AMCP meeting in a poster session title Estimating the prevalence and healthcare costs of diagnosed opioid abuse in a large commercial claims database.

The study analyzed Truven Health Analytics claims data for commercially-insured patients between 2009 and 2012. Truven’s Commercial MarketScan^® database contains de-identified medical and pharmacy claims for >60 million individuals covered by a number of health plans.

Study participants were followed for up to 18 months; the index data was the date of first opioid abuse/dependence diagnosis. Patients were then followed for 12 months. Patients were eligible for study inclusion if they had ≥1 diagnosis of opioid abuse/dependence, which was identified using the International Classification of Diseases, 9th Revision, Clinical Modification codes. Patients were also eligible if they had continuous enrollment in a noncapitated, nonhealth maintenance organization health plan during the study period. Patients 12 to 64 years of age were included.

Patients identified as opioid abusers were matched 1:1 with a patient not diagnosed with opioid abuse, used as a control. Abusers and controls were matched based on year of index date, baseline healthcare costs, and propensity score, including demographics, baseline comorbidities, baseline prescription drug use, and baseline healthcare resource use.

Of the 8,424,331 patients with ≥1 medical claim in the study period, 38,876 opioid abusers and 903,415 controls met the inclusion criteria. A total of 35,857 abusers (92.2%) were successfully matched to controls.

During the 12-month follow-up period, opioid abusers incurred $11,376 more in healthcare costs than their matched controls ($22,301 vs $10,925; P<.05). Overall medical costs were significantly higher for opioid abusers ($19,282 vs $8431), and prescription drug costs were also higher for abusers ($3019 vs $2494).

The study also found that the prevalence of diagnosed opioid abuser in the claims data increased from 15.8 per 10,000 individuals in 2009 to 26.6 per 10,000 individuals in 2012.

The researchers indicated limitations associated with the study, including the analysis relies on the accuracy of claims data to distinguish abusers from nonabusers and to evaluate their comorbidities and healthcare costs. Also, the study’s observational research design could have led to causal interpretation of the findings.

The authors noted that the study’s findings confirm previous research regarding excess healthcare costs associated with opioid abuse. The rising prevalence of diagnosed opioid abuse observed in the claims data during the 4-year period, may reflect an increased awareness of physicians to diagnose previously undiagnosed patients abusing opioids, according to the authors.

This study was funded by Purdue Pharma L.P.