Societal economic benefits associated with an extended-release opioid with abuse-deterrent technology in the United States.

Abstract

Common chronic pain conditions affect approximately 100 million U.S. adults and result in costs of $560–635 billion annually in direct medical treatment costs and lost productivity [1]. In addition, pain is a common cause of disability in the United States [2]. The Food and Drug Administration (FDA) has noted that prescription opioids (RxOs) are an important component of modern pain management [3]. At the same time, the agency has acknowledged that RxO abuse is a serious public health problem. The National Survey on Drug Use and Health (NSDUH) reported that 1.8 million of the U.S. population ages 12 and up had prescription painkiller abuse or dependence in 2011 [4]. In 2007, RxO abuse accounted for an estimated $55.7 billion (US$ 2009) in annual societal costs in the United States [5]. These costs include health care, workplace, and criminal justice costs. Extended-release opioids (EROs) provide a longer period of drug release and can thus be taken less frequently than immediate-release opioids [6]. However, EROs can be manipulated and tampered with in an attempt to overcome their extended-release properties. Because of their higher drug dosages, EROs may be more attractive to some abusers than immediate-release formulations [7]. Manufacturers of EROs have attempted to address the problem of RxO abuse by developing formulations with abuse-deterrent properties. For example, reformulated extended-release oxycodone HCl with abuse-deterrent technology (reformulated ER oxycodone) was introduced in August 2010 and replaced the original formulation of ER oxycodone without abuse-deterrent technology. Several studies have examined the impact of reformulated ER oxycodone among abusers. A study on the attractiveness of reformulated ER oxycodone relative to other opioid formulations among recreational opioid abusers found that reformulated ER oxycodone was rated the least attractive, least valuable, least desirable, and least likely to be tampered with among …