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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


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


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