Costs of Opioid Abuse and Misuse Determined From a Medicaid Database

Abstract

This study determined the associations between opioid abuse, dependence, and poisonings on costs and comorbidities in the Medicaid population. Medicaid patients in the Medicaid Analytic eXtract (MAX) files from 2002 to 2003 with 12 months of continuous eligibility, age >or=12 years, and with an opioid abuse/dependence-related diagnosis, including opioid abuse, dependence, or poisoning, in 2002 (index date) were matched 3:1 to Medicaid patients with no such diagnosis (controls). Medical costs by claim type incurred 12 months post index date were compared as was the prevalence of select comorbidities. The authors conducted a two-step multivariate regression analysis adjusted for patient characteristics that could influence cost outcomes. Opioid abuse/dependence prevalence was 8.7 per 1000 in 2002-2003. A total of 50,162 patients with abuse or dependence-related diagnoses were matched to 150,486 control patients. Total costs were significantly higher for the abuse/dependence patients ($14,537) than matched controls ($8,663) (P < .001). When controlling for baseline characteristics, adjusted costs continued to be higher for abuse/dependence patients ($23,556 versus $8,436; P < .001). A total of 83.7% of abuse/dependence patients and 51.6% of controls had >or=1 of the predefined comorbidities. Other substance abuse (odds ratio [OR] 9.4), hepatitis A, B, or C (OR 8.8), and poisonings (OR 8.5) were highly associated with a diagnoses for opioid abuse or dependence (P < .001). Medicaid opioid abuse/dependence patients had more comorbidities and higher medical costs in 2002-2003 than Medicaid control patients. Successful interventions to prevent opioid abuse and manage comorbidities could help to reduce costs associated with opioid abuse in the Medicaid population.

Preoperative Opioid Misuse is Associated With Increased Morbidity and Mortality After Elective Orthopaedic Surgery

“…Maeda et al [33] recently reported that the prevalence of opioid abuse and dependence in women hospitalized for delivery across the United States increased by 127%, from 1.7 per 1000 delivery admissions in 1998 to 3.9 per 1000 delivery admissions in 2011. Although the observed frequency of opioid abuse and dependence among orthopaedic surgical inpatients could be considered small, the clinical and economic burdens to healthcare systems are substantial [30,36,40,44].…”

Prescription Opioid Abuse: A Literature Review of the Clinical and Economic Burden in the United States

“…28,31 Among the 4 studies, comorbidities were reported to occur at a higher rate in individuals who chronically use or abuse opioids compared to those who do not use opioids. 24,26,28,31 Economic burden of prescription opioid abuse Resource utilization. Eight studies examined resource utilization among the prescription opioid abuse population (Table 6).…”

“…2,17,22 When compared to a matched control group (non-abusers), mean annual excess health care costs for opioid abusers with private insurance ranged from $14,054 to $20,546. 21,22,24,28 White and colleagues 21 assessed opioid abuse patients and demographically matched controls using privately insured (Ingenix Employer Solutions Data) and Florida Medicaid administrative claims data from 2003 to 2007. Privately insured opioid abuse patients (n = 4474) incurred $24,193 in total direct health care costs per patient; in contrast, privately insured non-opioid abuse controls (n = 4474) incurred only $3647 in total direct health care costs per patient, amounting to a mean annual excess of $20,546 in health care costs for opioid abusers.…”

“…Studies in this review showed that the mean annual excess health care costs for opioid abusers with Medicaid ranged from $5874 to $15,183. 21,22,24,28 Treatment of prescription opioid abuse Cost of treatment. Two studies examined the cost of prescription opioid abuse treatment (Table 8).…”

Strategies aimed at controlling misuse and abuse of opioid prescription medications in a state Medicaid program: a policymaker’s perspective

“…In a study by McAdam-Marx et al, costs for Medicaid patients with abuse/dependence-related diagnoses were higher than costs for patients without a related diagnosis. The authors suggest interventions targeted at preventing abuse and managing comorbidities in these patients can reduce costs and potential abuse (3).…”