PMS67 DIFFERENCES IN HEALTHCARE EXPENDITURE BETWEEN OPIOID AND NON-OPIOID USERS AMONG A NATIONAL SAMPLE OF COMMUNITY-BASED OLDER UNITED STATES ADULTS WITH PAIN, 2015

Abstract

Increasing numbers of older adults using opioids presents healthcare challenges in the United States (US). This study compared healthcare expenditures between older US adults (≥50 years) with pain who use opioid medications and those who do not. This study employed a retrospective, cross-sectional database design using 2015 Medical Expenditure Panel Survey (MEPS) data. Eligible participants were alive for the calendar year, aged 50 years or older, and reported having pain in the past four weeks. The key independent variable was opioid use status (opioid users defined using Multum Lexicon therapeutic class codes “60” or “191”). Hierarchical linear regression models were constructed to assess healthcare expenditures (inpatient, outpatient, office-based, emergency room, prescription medications, other, and total costs) between opioid users and non-opioid users, adjusting for appropriate covariates. National estimates were obtained by adjusting for the complex MEPS design. The study cohort consisted of 4,759 subjects (opioid users n=1,525, non-opioid users n=3,234), providing a national estimate of 50,898,592 non-institutionalized older adults with pain in the US in 2015 (opioid users n=16,757,516 [32.9%], non-opioid users n=34,141,076 [67.1%]). In univariate analysis, opioid use was associated with all personal characteristics (p<0.05), except gender and race. After adjusting for predisposing, enabling, need, personal health practices, and external environmental factors, opioid users had 61% greater outpatient expenditure (β=0.477, p<0.0001), 69% greater office-based expenditure (β=0.524, p<0.0001), 14% greater emergency room expenditure (β=0.131, p=0.0045), 63% greater prescription medication expenditure (β=0.486, p<0.0001), 29% greater other healthcare expenditure (β=0.251, p=0.0002), and 105% greater total healthcare expenditure (β=0.718, p<0.0001) than non-users. There was no difference in inpatient expenditures (p>0.05) between opioid users and non-users. Adjusted healthcare expenditures were greater among opioid users compared to non-users for all expenditure categories, except inpatient expenditures. Future research should investigate these variables in greater depth, over longer time periods, and additional populations.