Cancer and non-cancer pain opioid utilization in Medicare and Medicaid populations.

Abstract

139 Background: Limited data exist comparing opioid use patterns in Medicare and Medicaid patients with cancer-related (CP) and non-cancer-related pain (NCP). Methods: A retrospective analysis of Medicare and Medicaid claims data (MarketScan Research Databases) investigated opioid use patterns in patients with CP and NCP. Adults (age ≥18 yr) with ≥1 pharmacy claim for an opioid (index date), continuous plan eligibility for 6 months pre- and 12 months post-index date, and duration of opioid use of ≥4 weeks were identified. CP patients were identified by medical claim for a cancer diagnosis within 30 days before index date. Results: A total of 4,009 Medicare and 551 Medicaid patients with CP and 98,631 Medicare and 25,163 Medicaid patients with NCP were analyzed. The most common cancer diagnoses were breast, lung, prostate, and colorectal. Medicare patients with CP and NCP had similar mean age; in the Medicaid cohort, patients with CP were older than those with NCP. In the Medicare cohort, NCP patients were more likely to be women; sex distribution was similar among Medicaid patients. Higher rates of comorbidity in the CP cohorts were observed in both datasets. Median index and post-index opioid doses were consistent between the CP and NCP cohorts. The post-index pattern of change in opioid dose was consistent between CP and NCP in both Medicare and Medicaid patients. The most common pattern observed was up to a doubling of index dose. Conclusions: Similar opioid utilization patterns in Medicare and Medicaid populations, including dose escalation, were observed regardless of pain etiology (cancer or non-cancer). [Table: see text]