Healthcare Expenditures Associated with Persistent Opioid use Among Adults with Chronic Non-Cancer Pain Conditions: A Retrospective Cohort Study

Abstract

Persistent opioid use in adults with chronic non-cancer pain (CNCP) conditions may lead to high economic burden due to adverse events associated with opioids. The objective of our study was to estimate the healthcare expenditures associated with persistent opioid use among adults with CNCP from both payer and patient perspectives. A retrospective cohort study using data from the Medical Expenditure Panel Survey (2012–2015) was undertaken. Patients with persistent, intermittent, and no opioid use in the baseline year were identified and their healthcare expenditures in the follow-up year were examined after controlling for potential confounders. In all, 7,286 adults with CNCP matching our inclusion criteria were identified: 14%, 16%, and 70% reported persistent, intermittent, and no opioid use, respectively. Persistent and intermittent opioid use were associated with additional $4,412 ($12,468 vs $8,056; P < .001) and $1,607 ($9,663 vs $8,056; P = .004), respectively, in total healthcare expenditures compared to no opioid use. Moreover, persistent opioid use was associated with high out-of-pocket burden compared to no opioid use (adjusted odds ratio, 1.44; 95% confidence interval, 1.09–1.89). Our study shows that both payers and patients bear the brunt of economic burden of persistent opioid use. Alternative cost-effective strategies for pain management for this group of patients are needed.

Keywords:

• Health expenditures
• chronic pain
• opioid analgesics
• costs and cost analysis
• economic burden

Disclosure statement

The authors report no conflicts of interest.

Data availability

Data used in current study are publicly available online on the Agency for Healthcare Research and Quality’s website at https://meps.ahrq.gov/mepsweb/.

Additional information

Funding

This work was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number U54GM104942, WVCTSI.