Purdue Pharma L.P., a privately-held pharmaceutical company, presented results from two studies evaluating the excess healthcare costs of opioid abuse and misuse, quantifying the overall economic burden as well as individual cost drivers from a payer perspective at the 10th Annual PAINWeek Conference in Las Vegas, Sept 6-10.
As noted in a press release, the first study titled, “The economic burden of opioid abuse and its drivers: evidence from a payer perspective,” investigated the current estimates of the excess costs of opioid abuse from a payer perspective both before and after abuse diagnosis, and the drivers of these excess costs.
This study analyzed claims data from approximately eight million commercially-insured patients from the Truven MarketScan Commercial Claims and Encounters Database that reported at least one diagnosis of opioid abuse, dependence, or poisoning or overdose (“Opioid Abuse”). The study found that Opioid Abuse was associated with $11,470 in excess costs during the 12 months surrounding an initial Opioid Abuse episode.
Excess costs began increasing well before the initial diagnosis, with non-opioid drug abuse treatment comprising a substantial proportion of the excess costs of Opioid Abuse before incident diagnosis. Moreover, 28% of the excess costs following Opioid Abuse diagnosis were driven by costs of treating non-Opioid Abuse, compared to 31% for Opioid Abuse.
- Abusers were identified using ICD-9-CM diagnosis codes for opioid abuse / dependence / poisoning / overdose, but a substantial share of abusers may be undiagnosed. These undiagnosed abusers would not be captured in this analysis; to the extent that undiagnosed abusers are included in the control cohort, the estimated excess costs of abuse may be conservatively estimated. Truven MarketScan Commercial Claims and Encounters claims data were used in this study, and the data may not be generalizable to the overall U.S. population. In addition, this study relied on the accuracy of claims data, and any miscoding in the underlying data could affect our results.
The second study titled, “The costs and cost drivers of opioid misuse by diagnosis: abuse, dependence, and overdose/poisoning,” analyzed a claims database of commercially-insured patients to calculate the collective costs of three conditions: opioid abuse, dependence, and overdose/poisoning (“Opioid Abuse”).
The study also investigated the specific drivers of excess costs at the diagnosis-level. The study showed that while all three conditions are associated with substantial excess costs, there are important differences across diagnosis categories in terms of places of service and cost drivers. Opioid overdose/poisoning in particular is associated with substantially higher excess costs related to care received in inpatient and emergency department settings. Conversely, opioid abuse and dependence diagnoses had similar costs despite somewhat different place-of-service distributions.
- Patients with opioid dependence, abuse, or overdose/poisoning diagnoses were identified using ICD-9-CM diagnosis codes, though a substantial share of abusers may be undiagnosed; to the extent that undiagnosed abusers are included in the control cohort, the estimated excess costs of abuse may be conservatively estimated. OptumHealth Reporting and Insights commercial claims data were used in this study, and the data may not be generalizable to the overall U.S. population. In addition, this study relied on the accuracy of claims data, and any miscoding in the underlying data could affect our results.
“These studies clearly highlight the complex nature of the costs associated with Opioid Abuse, which often occurs in the context of other substance abuse,” said lead author Jaren Howard, PharmD, BCPS, Associate Director, Medical Affairs Strategic Research, Purdue Pharma. “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.”
PAINWeek is the largest U.S. pain conference for frontline practitioners with an interest in pain management.