Abstract
BackgroundPrevious reports on healthcare costs and expenditures associated with populations prescribed an opioid primarily focused on populations who chronically use opioids or have opioid use disorder. However, studies that characterize the healthcare and expenditures costs among the wider number of people prescribed opioids in a nationally representative population are unavailable. We sought to characterize the healthcare costs and expenditures associated with a population prescribed an opioid in the U.S. from 2008 to 2017.MethodsA serial cross-sectional design was used to compare the economic burden of adult household respondents who were prescribed and not prescribed an opioid using pooled data from the Medical Expenditure Panel Survey (MEPS) between 2008 and 2017. Respondents with an opioid prescription were matched to respondents without an opioid prescription using propensity score match methods with survey weights. Two-part generalized linear models were used to estimate the survey-weighted annual healthcare expenditures and resource utilization adjusting for multiple covariates. Additionally, 10-year trend comparisons between the groups were performed. Costs were adjusted to 2019 US dollars.ResultsThere was a weighted total of 31,696,671 respondents with an opioid and 31,536,639 respondents without an opioid after propensity score matching. The sample had a mean (SD) age of 50.63 years (18.03), 58.9% females, and 81.6% Whites. Total annual economic burden among RPOs was $524 billion. Annual total expenditures per respondent with and without an opioid were $16,542 and $7067, respectively (P < 0.001). Similarly, adjusted prescription, outpatient, emergency department, and inpatient expenditures were significantly higher for respondents with an opioid compared to respondents without an opioid. Average annual increases in expenditures were significantly greater among respondents with an opioid compared to respondents without an opioid for total (+$185; 95% CI: $37–$334) and prescription (+$78; 95% CI: $28–$128) expenditures. There were no differences in the average annual trends for outpatient, emergency department, and inpatient expenditures between respondents with and without an opioid.ConclusionsRespondents with an opioid prescription had higher healthcare expenditures and resource utilization compared to respondents without an opioid prescription from 2008 to 2017. Specifically, significant annual increases were observed for total and prescription expenditures. Additionally, 10-year trends in total and prescription expenditures were higher among respondents with an opioid than respondents without an opioid.
Highlights
The opioid epidemic in the United States (U.S.) is one of the most devastating public health crises in recent decades
There was a weighted total of 31,696,671 respondents with an opioid and 31,536,639 respondents without an opioid after propensity score matching
Respondents with an opioid prescription had higher healthcare expenditures and resource utilization compared to respondents without an opioid prescription from 2008 to 2017
Summary
The opioid epidemic in the United States (U.S.) is one of the most devastating public health crises in recent decades. Previous reports on healthcare costs and expenditures associated with people who use opioids primarily focused on people who chronically use opioids or people with opioid use disorder or misuse. Kirson and colleagues [5], using administrative claims data between 2011 and 2015, reported that people who abuse opioids had significantly higher healthcare costs compared to people who use but do not abuse opioids, which were driven by substance use disorder diagnoses, mental health conditions, and pain conditions. Studies that characterize the healthcare and expenditures costs among the wider number of people who use opioids in a nationally representative population could provide payers with insight on the impact opioid prescribing has on their patient population. Previous reports on healthcare costs and expenditures associated with populations prescribed an opioid primarily focused on populations who chronically use opioids or have opioid use disorder. We sought to characterize the healthcare costs and expenditures associated with a population prescribed an opioid in the U.S from 2008 to 2017
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