Cost Drivers of Prescription Opioid Abuse in Commercial and Medicare Populations

Objective Growth in the number of patients with pain conditions, and the subsequent rise in prescription opioid use for treatment, has been accompanied by an increase in diagnosed opioid abuse. Understanding what drives the incremental healthcare costs of members diagnosed with prescription opioid abuse may assist in developing better screening techniques for abuse. Design This retrospective analysis examined costs, resource use, and comorbidities 365 days pre‐ and postdiagnosis in prescription opioid users diagnosed with abuse (cases) vs. their matched nondiagnosed controls. Inclusion criteria for cases were diagnosis of opioid abuse (ICD‐9‐CM: 304.0x, 304.7x, 305.5x, 965.0x). Multivariate analysis used generalized linear modeling with log‐transformed cost as dependent variable, controlling for comorbidities. Results Final sample sizes were 8,390 cases and 16,780 matched controls. Postindex abuse‐related costs were $2,099 for commercial members, $539 for Medicare members aged