Study: Chronic opioid therapy associated with increased healthcare spending and hospital stays

Amid public health concerns about the risks of opioid overuse, a recent study in The American Journal of Accountable Care^® (AJAC) shows increased economic burden on patients and payers when opioid therapy for noncancer pain continues beyond the initial prescription.

Using data from commercial insurance claims of working-aged adults, new research published in the December issue of The American Journal of Accountable Care^® (AJAC) found that chronic opioid therapy (COT) for noncancer pain is associated with increased healthcare spending as well as hospital stays. The insights from the study, "Increased Healthcare Utilization and Expenditures Associated With Chronic Opioid Therapy," can be used by payers to intervene after opioids are prescribed but before patients transition to long-term use.

Patients who transitioned to COT, which is defined as daily or near-daily use of opioids for at least 90 days, had total healthcare expenditures that were $4607 higher than those of patients who did not continue long-term opioid use. Total expenditures, without prescription drugs, were defined as the sum of emergency department, inpatient, physician, and other spending. Inpatient spending alone among the COT group was $2453 higher than that of patients who did not transition to COT.

The sample—derived from a random sample of commercial enrollees that was released under licensing from the IQVIA Real-World Data Adjudicated Claims database—comprised 3776 adults aged 28 to 63 years in the COT group and 16,425 adults in the non-COT group.

With approximately 126 million Americans experiencing some type of pain in the past 3 months, payers, government agencies, and medical associations are trying to encourage nonopioid therapies for chronic noncancer pain. In 2017, opioid-related deaths surged past 72,000, with the increase driven by synthetic opioids.

"Any intervention focused on curbing transition to COT has the potential to prevent inpatient use and can lead to cost savings for the payer(s)," the study noted, adding that reducing inpatient utilization benefits patients via improved quality of life and lower out-of-pocket costs.

The authors, two of whom received funding from the National Institutes of Health, did not include in their study information on types of pain, response to pain treatment, socioeconomic status, and other factors.

"We hope that these findings can help lay the foundation, including financial justification, for prevention programs related to identifying and curbing inappropriate chronic opioid use," said lead author Douglas Thornton, PharmD, PhD, of the College of Pharmacy at University of Houston.