Chronic Non-Cancer Pain and its Association with Healthcare Use and Costs Among Individuals with Obstructive Sleep Apnea

Abstract

Aim: To evaluate the impact of chronic non-cancer pain (CNCP) on healthcare use and costs among individuals diagnosed with obstructive sleep apnea (OSA). Materials & methods: Using the IQVIA PharMetrics^® Plus database, we identified individuals (18–64 years old) during 2007–2014, divided into two groups: OSA + CNCP versus OSA-only. Generalized linear models were used to analyze binary and count outcomes. Results: Relative to OSA-only controls, OSA + CNCP cases had increased odds for inpatient and emergency department visits and higher rates for physician office visits, non-physician outpatient visits, and prescription drug fills. Relative to controls, direct healthcare costs for cases were higher, primarily driven by inpatient and non-physician outpatient visit costs. Conclusion: Relative to OSA-only controls, OSA + CNCP cases displayed increased healthcare use and costs across all points of service.

Keywords::

• chronic non-cancer pain
• commercially insured adults
• direct medical costs
• healthcare use
• obstructive sleep apnea

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/pmt-2020-0012

Author contributions

All authors contributed toward conception or design of the work. AB Gandhi, JF Slejko, E Villalonga-Olives and E Onukwugha contributed toward data acquisition. Data analysis is credited to AB Gandhi. All authors contributed toward interpretation of the data, drafting the work and revising it critically for important intellectual content, and final approval of the version to be published.

Disclaimer

The statements, findings, conclusion, views and opinions contained and expressed in this manuscript are based in part on data obtained under license from IQVIA. Source: IQVIA PharMetrics^® Plus January 2006–December 2015, IQVIA. All Rights Reserved. The statements, findings, conclusion, views and opinions contained and expressed herein are not necessarily those of IQVIA or any of its affiliated or subsidiary entities.

Financial & competing interests disclosure

JF Slejko reports grants from the PhRMA foundation, PhRMA, Novartis Pharmaceuticals, Takeda Pharmaceuticals and consulting fees from Pfizer, Inc outside the submitted work. EM Wickwire reports grants from AASM Foundation, Department of Defense, Merck and ResMed, personal fees from Dayzz, Eisai, Merck and Purdue, and equity shareholder in WellTap, outside the submitted work. E Onukwugha reports grants from Bayer Healthcare Pharmaceuticals, Inc and Pfizer, and personal fees from Novo Nordisk, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

This study was approved by the local Institutional Review Board of the University of Maryland, Baltimore.

Additional information

Funding

JF Slejko reports grants from the PhRMA foundation, PhRMA, Novartis Pharmaceuticals, Takeda Pharmaceuticals and consulting fees from Pfizer, Inc outside the submitted work. EM Wickwire reports grants from AASM Foundation, Department of Defense, Merck and ResMed, personal fees from Dayzz, Eisai, Merck and Purdue, and equity shareholder in WellTap, outside the submitted work. E Onukwugha reports grants from Bayer Healthcare Pharmaceuticals, Inc and Pfizer, and personal fees from Novo Nordisk, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.