Both Chronic and Acute Opioid Users Have Increased Healthcare Utilization

Between 2000 and 2015, deaths from opioid prescriptions more than quadrupled, and evidence of long-term efficacy of opioids for chronic pain is limited. Researchers sought to quantify the healthcare resource utilization and direct costs among chronic and acute opioid users compared with those not on these medications. The results of the study were presented at the AMCP Annual Meeting during a poster session titled “Healthcare Resource Utilization and Costs in Chronic and Acute Opioid Users over 2 Years: A Cohort Analysis.”

This historical cohort study used claims data from the HealthCare 21 Business Coalition data warehouse, which represents regional employer members with more than 180,000 covered lives. Patients were included if they were 18 to 65 years with non-cancer–related pain, had continuous enrollment between January 1, 2015, and June 30, 2017, and had one prescription claim during the index year (July 1, 2015, to June 30, 2016).

The researchers categorized the 23,951 patients as:

• Chronic users: Those with 90 days of continuous opioid coverage during the index year (3.3%)
• Acute users: Those with one opioid fill for <90 days of continuous opioid coverage (25.5%)
• Non-opioid users: Those without any opioid prescription (71.2%)

The median patient age was 46.5 years (standard deviation, 12.3), and more than half (69.1%) were female.

Among opioid users, 17.2% of chronic users and 17.5% of acute users had one inpatient hospital stay compared with 6.6% of non-opioid users (P<0.001). At least one emergency department visit was reported in 43.3% of chronic users and 44.9% of acute opioid users compared with 22.2% of non-opioid users (P<0.001).

Generalized linear models revealed that chronic ($32,815) and acute ($21,006) opioid users incurred greater total mean healthcare costs compared with non-opioid users ($8,740; P<0.001) over a two-year period (2015-2017).

“Due to the increased economic burden and healthcare resource utilization associated with opioid use, other pain management approaches should be considered,” the researchers concluded. “Employer groups and payers may consider coverage of alternative treatment modalities, treatment services for opioid use disorder, and monitoring of opioid utilization.”

Voelker J, Bartolome L, Singer D, Crawford A, Fortner G, Goldfarb N. Healthcare Resource Utilization and Costs in Chronic and Acute Opioid Users over 2 Years: A Cohort Analysis. Abstract R1. Presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting, April 23-26; Boston, MA.