Lower costs were incurred among members with opioid use disorder (OUD) or overdose (OD) taking medication for addiction treatment, according to findings presented at AMCP Nexus 2022.

The study included Cigna’s US commercial members with OUD diagnosis or OD event between January 2020 and June 2020. For both medical and pharmacy coverages, members were continuously eligible 365 days from the diagnosis index date.

Excluded participants were members with a diagnosis of OUD remission, sickle cell disease, cancer, or those recorded having a hospice stay or Medicare benefits.

According to researchers, receiving any buprenorphine or naltrexone prescription approved for use in OUD within 30 days of an OD event or OUD diagnosis qualifies as medication for addiction treatment.

Researchers calculated total cost of care 365 days from the diagnosis index date, and capped at $100,000 to exclude outliers. Furthermore, proportion of days covered (PDC) was calculated 90 days from the medication for addiction treatment index date to assess adherence and PDC values were ranked in 5 categories: <0.20, ≥0.20 to <0.40, ≥0.40 to <0.60, ≥0.60 to <0.80, and ≥0.80.

Of 6835 members, 40% were female, 85% were Caucasian, 61% were employees, 27% were spouses, 12% were dependents, the average age was 41.6 years, and the average Elixhauser comorbidity score was 2.7.

Per results, 3938 (58%) of members were on medication for addiction treatment and among those, the total cost of care was $6000 lower than those not on medication for addiction treatment.

For 3897 members on medication for addiction treatment the PDC was calculated.

“The higher PDC (≥0.80, ≥0.60 to <0.80, ≥0.40 to <0.60, ≥0.20 to <0.40, <0.02) was associated with lower OD events (1%, 4%, 5%, 7%, 8%) and lower average total cost of care ($16,017, $23,962, $30,709, $35,227, $39,518),” reported researchers.

For members with PDC ≥0.80 (74%) the average total cost of care was $23,500 lower than those with PDC >0.20 (5%).

“Additionally, medication for addiction treatment members with higher adherence have lower OD rates and incur lower costs indicating better economic and clinical outcomes,” concluded study authors.

Reference:
Caffiero N, Acklin C, Swami S, Tao Z. Total cost of care associated with medication for addiction treatment in opioid use disorder. J Manag Care Spec Pharm. 2022;28(10-a suppl):S1-S137. doi:10.18553/jmcp.2022.28.10-a.s1