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 a...
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| Veröffentlicht in: | Pain practice 2014-03, Vol.14 (3), p.E116-E125 |
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| container_title | Pain practice |
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| creator | Pasquale, Margaret K. Joshi, Ashish V. Dufour, Robert Schaaf, David Mardekian, Jack Andrews, George A. Patel, Nick C. |
| description | 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 |
| doi_str_mv | 10.1111/papr.12147 |
| format | Article |
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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 < 65, and $170 for Medicare members aged ≥ 65. A higher percentage of cases had pain conditions (82.0% vs. 57.4% commercial, 95.9% vs. 87.5% Medicare members aged < 65, 92.9% vs. 82.4% Medicare members aged ≥ 65, P < 0.0001), and a higher numbers of cases had multiple opioid prescribers (3.7 vs. 1.4 commercial, 3.3 vs. 2.2 Medicare < 65, 2.2 vs. 1.6 Medicare ≥ 65, P < 0.0001) than controls preindex. Cases had higher rates of substance abuse and psychiatric diagnoses pre‐ and postindex (P < 0.0001, all comparisons). Adjusted costs were 28% higher for cases than for controls (P < 0.0001).
Conclusion
Costs of members diagnosed with prescription opioid abuse are driven by higher pain and psychiatric comorbidities relative to nonabuse controls.]]></description><identifier>ISSN: 1530-7085</identifier><identifier>EISSN: 1533-2500</identifier><identifier>DOI: 10.1111/papr.12147</identifier><identifier>PMID: 24268019</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analgesics, Opioid - economics ; Child ; Female ; Health Care Costs ; healthcare costs ; Humans ; Male ; Medicare - economics ; Middle Aged ; opioid abuse ; Opioid-Related Disorders - economics ; pharmacoeconomics ; prescription drug abuse ; Retrospective Studies ; United States ; Young Adult</subject><ispartof>Pain practice, 2014-03, Vol.14 (3), p.E116-E125</ispartof><rights>2013 World Institute of Pain</rights><rights>2013 World Institute of Pain.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3937-b518d8332244b7d8d244dbdd424c25c1971225ba39d670c4d5de1f246d271ef63</citedby><cites>FETCH-LOGICAL-c3937-b518d8332244b7d8d244dbdd424c25c1971225ba39d670c4d5de1f246d271ef63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpapr.12147$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpapr.12147$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24268019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pasquale, Margaret K.</creatorcontrib><creatorcontrib>Joshi, Ashish V.</creatorcontrib><creatorcontrib>Dufour, Robert</creatorcontrib><creatorcontrib>Schaaf, David</creatorcontrib><creatorcontrib>Mardekian, Jack</creatorcontrib><creatorcontrib>Andrews, George A.</creatorcontrib><creatorcontrib>Patel, Nick C.</creatorcontrib><title>Cost Drivers of Prescription Opioid Abuse in Commercial and Medicare Populations</title><title>Pain practice</title><addtitle>Pain Pract</addtitle><description><![CDATA[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 < 65, and $170 for Medicare members aged ≥ 65. A higher percentage of cases had pain conditions (82.0% vs. 57.4% commercial, 95.9% vs. 87.5% Medicare members aged < 65, 92.9% vs. 82.4% Medicare members aged ≥ 65, P < 0.0001), and a higher numbers of cases had multiple opioid prescribers (3.7 vs. 1.4 commercial, 3.3 vs. 2.2 Medicare < 65, 2.2 vs. 1.6 Medicare ≥ 65, P < 0.0001) than controls preindex. Cases had higher rates of substance abuse and psychiatric diagnoses pre‐ and postindex (P < 0.0001, all comparisons). Adjusted costs were 28% higher for cases than for controls (P < 0.0001).
Conclusion
Costs of members diagnosed with prescription opioid abuse are driven by higher pain and psychiatric comorbidities relative to nonabuse controls.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analgesics, Opioid - economics</subject><subject>Child</subject><subject>Female</subject><subject>Health Care Costs</subject><subject>healthcare costs</subject><subject>Humans</subject><subject>Male</subject><subject>Medicare - economics</subject><subject>Middle Aged</subject><subject>opioid abuse</subject><subject>Opioid-Related Disorders - economics</subject><subject>pharmacoeconomics</subject><subject>prescription drug abuse</subject><subject>Retrospective Studies</subject><subject>United States</subject><subject>Young Adult</subject><issn>1530-7085</issn><issn>1533-2500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMlOwzAURS0EYihs-ADkJUIKeIjjZFkFKIjShkksLcd2JENSB7th-HtSUljyNvctzj2LC8AhRqe4v7NWtv4UExzzDbCLGaURYQht_vwo4ihlO2AvhBeEMM8o3QY7JCZJinC2C4rchSU89_bd-ABdBQtvgvK2XVq3gPPWOqvhuOyCgXYBc9c0xisraygXGt4abZX0Bhau7Wq5qoR9sFXJOpiDdY7A0-XFY34VTeeT63w8jRTNKI9KhlOdUkpIHJdcp7pPXWodk1gRpnDGMSGslDTTCUcq1kwbXJE40YRjUyV0BI4Hb-vdW2fCUjQ2KFPXcmFcFwRmiBHGKMl69GRAlXcheFOJ1ttG-i-BkVgtKFYLip8Fe_ho7e3Kxug_9HeyHsAD8GFr8_WPShTj4v5XGg0dG5bm868j_atIOOVMPM8mYvZApjd39Fkg-g0nbInK</recordid><startdate>201403</startdate><enddate>201403</enddate><creator>Pasquale, Margaret K.</creator><creator>Joshi, Ashish V.</creator><creator>Dufour, Robert</creator><creator>Schaaf, David</creator><creator>Mardekian, Jack</creator><creator>Andrews, George A.</creator><creator>Patel, Nick C.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201403</creationdate><title>Cost Drivers of Prescription Opioid Abuse in Commercial and Medicare Populations</title><author>Pasquale, Margaret K. ; Joshi, Ashish V. ; Dufour, Robert ; Schaaf, David ; Mardekian, Jack ; Andrews, George A. ; Patel, Nick C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3937-b518d8332244b7d8d244dbdd424c25c1971225ba39d670c4d5de1f246d271ef63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analgesics, Opioid - economics</topic><topic>Child</topic><topic>Female</topic><topic>Health Care Costs</topic><topic>healthcare costs</topic><topic>Humans</topic><topic>Male</topic><topic>Medicare - economics</topic><topic>Middle Aged</topic><topic>opioid abuse</topic><topic>Opioid-Related Disorders - economics</topic><topic>pharmacoeconomics</topic><topic>prescription drug abuse</topic><topic>Retrospective Studies</topic><topic>United States</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pasquale, Margaret K.</creatorcontrib><creatorcontrib>Joshi, Ashish V.</creatorcontrib><creatorcontrib>Dufour, Robert</creatorcontrib><creatorcontrib>Schaaf, David</creatorcontrib><creatorcontrib>Mardekian, Jack</creatorcontrib><creatorcontrib>Andrews, George A.</creatorcontrib><creatorcontrib>Patel, Nick C.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pain practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pasquale, Margaret K.</au><au>Joshi, Ashish V.</au><au>Dufour, Robert</au><au>Schaaf, David</au><au>Mardekian, Jack</au><au>Andrews, George A.</au><au>Patel, Nick C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost Drivers of Prescription Opioid Abuse in Commercial and Medicare Populations</atitle><jtitle>Pain practice</jtitle><addtitle>Pain Pract</addtitle><date>2014-03</date><risdate>2014</risdate><volume>14</volume><issue>3</issue><spage>E116</spage><epage>E125</epage><pages>E116-E125</pages><issn>1530-7085</issn><eissn>1533-2500</eissn><abstract><![CDATA[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 < 65, and $170 for Medicare members aged ≥ 65. A higher percentage of cases had pain conditions (82.0% vs. 57.4% commercial, 95.9% vs. 87.5% Medicare members aged < 65, 92.9% vs. 82.4% Medicare members aged ≥ 65, P < 0.0001), and a higher numbers of cases had multiple opioid prescribers (3.7 vs. 1.4 commercial, 3.3 vs. 2.2 Medicare < 65, 2.2 vs. 1.6 Medicare ≥ 65, P < 0.0001) than controls preindex. Cases had higher rates of substance abuse and psychiatric diagnoses pre‐ and postindex (P < 0.0001, all comparisons). Adjusted costs were 28% higher for cases than for controls (P < 0.0001).
Conclusion
Costs of members diagnosed with prescription opioid abuse are driven by higher pain and psychiatric comorbidities relative to nonabuse controls.]]></abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24268019</pmid><doi>10.1111/papr.12147</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Analgesics, Opioid - economics Child Female Health Care Costs healthcare costs Humans Male Medicare - economics Middle Aged opioid abuse Opioid-Related Disorders - economics pharmacoeconomics prescription drug abuse Retrospective Studies United States Young Adult |
| title | Cost Drivers of Prescription Opioid Abuse in Commercial and Medicare Populations |
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