番茄社区

LAS VEGAS -- Opioid abuse was tied to excess healthcare costs of over $10,000 for the 1 year following the initial abuse diagnosis, researchers reported here.

In a review of a large healthcare cost database, there was a statistically significant difference in medical and prescription drug costs among patients who had at least one diagnosis of opioid abuse, dependence, or poisoning overdose compared with matched controls ($25,523 vs $13,573), reported , of Purdue Pharmaceuticals in Stamford, Conn., and colleagues.

Howard told 番茄社区 that current literature had placed the incremental cost of a diagnosed abuser compared to a non-diagnosed abuser in the $10,000-$20,000 range, so the fact that their findings matched current estimates was somewhat reassuring.

"It's important to look at opioid abuse at a granular level to understand it," he said at a poster presentation at Pain Week. "I think our work highlights the fact that opioid abuse is complex in nature and often occurs in the context of other substance abuse."

The authors used the Truven Marketscan database to identify medical claims of adults ages 18-64 who had been diagnosed with opioid abuse via ICD-9 codes (n=81,404) compared to propensity-score matched controls with at least one medical claim (n=1,818,792).

Overall, the mean 1 year excess difference in costs between opioid abusers and controls was $11,470. Howard and colleagues then broke out these costs by month, and expanded their data to include a 6- month baseline period.

"When we looked at the time period, we saw that excess begins to increase well before the formal diagnosis of abuse and then starts to decline in the 6 months following, but interestingly, it never reaches the level of pre-diagnosis," Howard said.

Indeed, the mean excess of healthcare costs in the month prior to a diagnosis of opioid abuse was $786, and a mean excess of $876 at the 6-month mark following an abuse diagnosis. Not surprisingly, the month of diagnosis was linked to the largest excess of healthcare costs ($3,658 mean excess).

The authors then examined the medical factors driving these costs and found a mixture of diagnoses related to opioids, substance abuse, and other physical and mental health issues. The four most prominent ICD-9 categories driving costs were:

• Opioid abuse
• Non-opioid abuse and dependence
• Painful conditions
• Mental health disorders

They then found that rehabilitation and treatment of opioid use comprised the majority of costs in the 6 months following a diagnosis of abuse (31% of costs related to opioid abuse treatment, while 28% related to non-opioid substance abuse). Mental health disorders (8%) and back pain and other painful conditions (5%) also played a small role in excess costs.

But the medical picture was slightly more mixed in the 6 months prior to an abuse diagnosis, with non-opioid drug dependence comprising 18% of excess costs, followed by back pain and other painful conditions (12%) and mental health disorders (5%).

When examining these excess costs per patient by place of service, rehabilitation facilities comprised 41% of excess costs, followed closely by inpatient facilities (36%), and emergency departments (10%).

"Further insights into the drivers of excess costs of opioid abuse can help educate both payers and providers on the most efficient way to treat abusers, with the possibility that opioid abuse might be averted if preceding substance use issues, especially those involving alcohol, were better treated," Howard concluded in a statement.

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