The economic burden of neonatal abstinence syndrome in the United States

Abstract

The incidence of neonatal abstinence syndrome is increasing in the United States, and carries an enormous burden in terms of hospital days and costs. The number of US hospital admissions involving neonatal abstinence syndrome increased more than fourfold between the years 2003 and 2012. In 2012, neonatal abstinence syndrome cost nearly $316 million in the United States.

Incidence and Costs of Neonatal Abstinence Syndrome Among Infants With Medicaid: 2004–2014

“…To obtain hospital costs, we used Agency for Healthcare Research and Quality's cost-to-charge ratio files to convert charges. 8,12 We applied the cost-to-charge ratio to each charge in our analytic sample and inflationadjusted resultant costs to 2014 dollars by using the Consumer Price Index for All Urban Consumers. 13 We aggregated hospital costs for all NAS births covered by Medicaid in each year of our study.…”

“…3,5 Furthermore, although reports of hospital costs for NAS-related care exist, there are no data describing aggregate NASrelated hospital costs among infants enrolled in Medicaid, nationally. 8,9 Hospital costs are important to consider because Medicaid does not reimburse on the basis of charges but on a schedule often closer to costs. Information regarding NAS incidence and costs could help state and federal health officials target efforts to improve care delivery for infants with the syndrome, expand treatment for pregnant women, and prevent NAS.…”

Torticollis in Infants with a History of Neonatal Abstinence Syndrome

“…The healthcare costs associated with treating infants with NAS in the hospital has increased over the last several years. 1,14 Additional healthcare expenditures for infants with a history of NAS after discharge from the hospital has not been estimated but could continue to soar because these children are at risk for ongoing medical and developmental issues. In our study, 28% of infants with torticollis received assistance through state-sponsored early intervention programs and more than one-half required additional outpatient physical therapy for their torticollis, despite exercises and stretching regimens that were provided in clinic.…”

Treatment of opioid withdrawal in neonates with morphine, phenobarbital, or chlorpromazine: a randomized double-blind trial

“…The incidence of withdrawal symptoms in newborns exposed to opioids during pregnancy, termed neonatal abstinence syndrome, has increased in the last 20 years and has reached epidemic proportions in high-income countries (2-6/1000 live births) [2]. Neonatal abstinence syndrome not only poses an important burden of suffering on infants and families but also contributes to the occupancy of neonatal beds and generates considerable health care costs [5].…”