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Prevalence and cost of diagnosed opioid abuse in a privately insured population in the United States

Carl L. Roland, PharmD, Ashish V. Joshi, PhD, Jack Mardekian, PhD, Steven C. Walden, PharmD, MBA, James Harnett, PharmD, MS

Abstract


Objective: To evaluate the prevalence, characteristics, associated healthcare resource utilization (HRU), and costs of diagnosed prescription opioid abusers (abusers) in a managed care population.

Methods: Patients aged 12 years with a claim for opioid abuse were identified in the Thomson MarketScan Commercial and Medicare Supplemental research databases between January 1, 2005 and September 30, 2010. HRU and costs (per patient per month) were calculated for all patients with an index date (date of opioid abuse diagnosis) from October 1, 2008 to September 30, 2009 and continuous eligibility through 6 months prior to (preindex) and 12 months after (postindex) date. Abusers were matched 1:3 on demographics to nonabusers.

Results: The overall prevalence of diagnosed opioid abuse was 0.195 percent during 2005-2010, with a twofold increase from 2005 to 2010. Diagnosed abuse was more prevalent in males (0.220 percent), those aged 18-25 years (0.271 percent), those from the Northeast region (0.231 percent), those with a comorbidity of pain (0.462 percent), and those with an opioid prescription (0.924 percent). A total of 15,398 abusers were matched to 46,194 nonabusers. Medical comorbidities were significantly higher (all p < 0.0001) in abusers versus nonabusers in the preindex and postindex periods. Each healthcare resource measured was significantly higher for abusers than nonabusers in the preindex and postindex periods (p < 0.0001). Total all-cause costs were higher for abusers than nonabusers in the preindex ($1,856 vs $372, respectively) and postindex ($2,138 vs $408) periods (p < 0.0001).

Conclusions: Opioid abuse increased over time and abusers were associated with significantly greater HRU and costs compared with nonabusers before and after the diagnosis of abuse.

Keywords: opioid abuse, prevalence, healthcare resource utilization, cost

DOI:10.5055/jom.2013.0158


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References


Institute of Medicine: Relieving pain in America: A blueprint for transforming prevention, care, education, and research. Available at http://www.iom.edu/~/media/Files/Report%20Files/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research/Pain%20Research% 202011%20Report%20Brief.pdf. Accessed February 16, 2012.

Trescot AM, Glaser SE, Hansen H, et al.: Effectiveness of opioids in the treatment of chronic non-cancer pain. Pain Physician. 2008; 11(2 suppl): S181-S200.

Volkow ND, McLellan TA: Curtailing diversion and abuse of opioid analgesics without jeopardizing pain treatment. JAMA. 2011; 305(13): 1346-1347.

Paulozzi L, Jones C, Mack K, et al.: Vital signs: Overdoses of prescription opioid pain relievers—United States, 1999-2008. MMWR Morb Mortal Wkly Rep. 2011; 60(43): 1487-1492.

Centers for Disease Control and Prevention: Unintentional drug poisoning in the United States. Available at http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-brief.pdf. Accessed January 30, 2012.

Questions and Answers: Questions and Answers: FDA approves a Risk Evaluation and Mitigation Strategy (REMS) for Extended-Release and Long-Acting (ER/LA) Opioid Analgesics. 2012. Available at http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm309742.htm. Accessed April 6, 2012.

Substance Abuse and Mental Health Services Administration: Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Available at http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm. Accessed October 4, 2011.

Birnbaum HG, White AG, Schiller M, et al.: Societal costs of prescription opioid abuse, dependence, and misuse in the United States. Pain Med. 2011; 12(4): 657-667.

Hansen RN, Oster G, Edelsberg J, et al.: Economic costs of nonmedical use of prescription opioids. Clin J Pain. 2011; 27(3): 194-202.

Coalition Against Insurance Fraud: Prescription for peril: How insurance fraud finances theft and abuse of addictive prescription drugs. Available at http://www.insurancefraud.org/downloads/drugDiversion.pdf. Accessed February 28, 2012.

White AG, Birnbaum HG, Schiller M, et al.: Economic impact of opioid abuse, dependence, and misuse. Am J Pharm Benefits. 2011; 3(4): e59-e70.

McAdam-Marx C, Roland CL, Cleveland J, et al.: Costs of opioid abuse and misuse determined from a Medicaid database. J Pain Palliat Care Pharmacother. 2010; 24(1): 5-18.

White AG, Birnbaum HG, Mareva MN, et al.: Direct costs of opioid abuse in an insured population in the United States. J Manag Care Pharm. 2005; 11(6): 469-479.

Quan H, Sundararajan V, Halfon P, et al.: Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005; 43(11): 1130-1139.

Morales A: Prescription abuse in Appalachia. Available at http://www.nytimes.com/slideshow/2011/04/03/us/DRUGS.html. Accessed May 9, 2012.

King L: OxyContin, not bath salts, is the drug of choice of Appalachian addicts. Available at http://communities.washingtontimes.com/neighborhood/appalachian-chronicles/2012/jun/9/OxyContin-Bath-Salts-drug-Appalachia-addicts/. Accessed June 16, 2012.

Rice JB, White AG, Birnbaum HG, et al.: A model to identify patients at risk for prescription opioid abuse, dependence, and misuse. Pain Med. 2012; 13(9): 1162-1173.

Hays LR: A profile of OxyContin addiction. J Addict Dis. 2004; 23(4): 1-9.

International Narcotics Control Board: Statistical information on narcotic drugs, part 4. Available at http://www.incb.org/doc

uments/Narcotic-Drugs/Technical-Publications/ 2011/Part_FOUR_Complete_English-NAR-Report-2011.pdf. Accessed March 8, 2012.




DOI: https://doi.org/10.5055/jom.2013.0158

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