Abstract
Objectives:
In the US, prescription opioids with technology designed to deter abuse have been introduced to deter drug abuse without hindering appropriate access for pain patients. The objective of this study was to estimate changes in medical costs following the introduction of a new formulation of extended-release (ER) oxycodone HCl (oxycodone) with abuse-deterrent technology in the US.
Methods:
Health insurance claims data were used to estimate changes in rates of diagnosed opioid abuse among continuous users of extended-release opioids (EROs) following the introduction of reformulated ER oxycodone in August 2010. This study also calculated the excess medical costs of diagnosed opioid abuse using a propensity score matching approach. These findings were integrated with published government reports and literature to extrapolate the findings to the national level. All costs were inflated to 2011 US dollars.
Results:
The introduction of reformulated ER oxycodone was associated with relative reductions in rates of diagnosed opioid abuse of 22.7% (p < 0.001) and 18.0% (p = 0.034) among commercially-insured and Medicaid patients, respectively. There was no significant change among Medicare-eligible patients. The excess annual per-patient medical costs associated with diagnosed opioid abuse were $9456 (p < 0.001), $10,046 (p < 0.001), and $11,501 (p < 0.001) for commercially-insured, Medicare-eligible, and Medicaid patients, respectively. Overall, reformulated ER oxycodone was associated with annual medical cost savings of ∼$430 million in the US.
Limitations:
Because of the observational research design of this study, caution is warranted in any causal interpretation of the findings. Portions of the study relied on prior literature, government reports, and assumptions to extrapolate the national medical cost savings.
Conclusions:
This study provides evidence that reformulated ER oxycodone has been associated with reductions in abuse rates and substantial medical cost savings. Payers and policy-makers should consider these benefits as they devise and implement new guidelines and policies in this therapeutic area.
Transparency
Declaration of funding
This study was funded by Purdue Pharma, L.P.
Declaration of financial/other relationships
RBJ is an employee of Purdue Pharma L.P.; NYK, AS, AGW, and HGB are employees of Analysis Group, Inc., a consulting company that received funding for this research from Purdue Pharma L.P. LFR and EM are consultants on this project and received funding from Analysis Group. JME Peer Reviewers on this manuscript have no relevant financial or other relationships to disclose.
Acknowledgments
The authors gratefully acknowledge the contributions of Katharine Bodnar, Alice Kate Cummings, Michael Kaminsky, and Sarah King.