Characterizing downstream healthcare resource utilization and costs based on prior utilization patterns of immediate-release hydrocodone

Figures & data

Figure 1. Sample selection. *Prescriptions for IR hydrocodone that were not pain-related (e.g., antitussive or sympathomimetic) were excluded.

Table 1. Patient baseline characteristics.

Days’ supply	Commercial				Medicare				Medicaid
	All n = 1,698,845	<60 n = 1,527,417	≥60 n = 171,428	≥90 n = 133,203	All n = 264,038	<60 n = 210,507	≥60 n = 53,531	≥90 n = 40,191	All n = 151,063	<60 n = 117,692	≥60 n = 33,371	≥90 n = 27,117
Age, Mean (SD)	44.2 (13.7)	43.5 (13.9)	50.6* (9.6)	50.7* (9.4)	75.3 (7.7)	75.3 (7.5)	75.1* (8.4)	74.8* (8.5)	37.1 (15.7)	34.0 (15.3)	47.8* (11.6)	48.1* (11.4)
Gender, Female (%)	56.2	56.3	55.4*	55.3*	56.3	55.1	61.1*	60.9*	72.0	73.0	68.3*	67.9*
CCI, Mean (SD)	0.7 (1.2)	0.6 (1.2)	1.0* (1.3)	1.0* (1.3)	1.8 (1.9)	1.8 (1.9)	1.9* (1.8)	1.8 (1.8)	1.3 (1.8)	1.1 (1.7)	2.0* (1.9)	2.0* (1.8)
All-cause costs during 6-month pre-index baseline, Mean (SD)	$8455 ($20,309)	$8377 ($20,161)	$9147* ($21,571)	$8480* ($19,819)	$13,207 ($26,119)	$13,808 ($27,304)	$10,840* ($20,647)	$10,115* ($19,068)	$7,810 ($24,179)	$7,165 ($24,220)	$10,086* ($23,894)	$9767* ($22,490)

*p-value is <0.05 as compared with <60 days’ supply group.

Figure 2. Any HRU event during the 12-month follow-up period, by baseline days’ supply or doses per month of IR hydrocodone for commercial patients. *p-value is <0.05 vs <60 days’ supply or ≤60 doses/month.

Figure 3. PPPM costs for commercial patients.

Figure 4. Odds ratio of HRU event by baseline days’ supply or doses per month of IR hydrocodone for commercial patients. All HRU events have p-value <0.05 for comparison against <60 days’ supply or ≤60 doses/month.

Table 2. Predicted, adjusted all-cause total costs during the 12-month follow-up based on regression analyses. Adjusted all-cause total costs by baseline days’ supply for IR hydrocodone.

Baseline days’ supply	<60	≥60	≥90
All-cause total costs at 12- month follow-up
Commercial	$851	$1245*	$1245*
Medicare	$1596	$1954*	$1973*
Medicaid	$1206	$1372*	$1368*

*p-value is <0.05 vs <60 days’ supply.

Table 3. Predicted, adjusted all-cause total costs during the 12-month follow-up based on regression analyses. Adjusted all-cause total costs by baseline average doses per month for IR hydrocodone.

Baseline doses per month	≤60	>60	≥90	≥120
All-cause total costs at 12- month follow-up
Commercial	$864	$1250*	$1247*	$1256*
Medicare	$1617	$1959*	$1937*	$1925*
Medicaid	$1225	$1376*	$1389*	$1429*

*p-value is <0.05 vs ≤60 doses per month.

Number of HRU events during the 12-month follow-up period.

Baseline days’ supply		Commercial				Medicare				Medicaid
	All (n = 1,698,845)	<60 (n = 1,527,417)	≥60 (n = 171,428)	≥90 (n = 133,203)	All (n = 264,038)	<60 (n = 210,507)	≥60 (n = 53,531)	≥90 (n = 40,191)	All (n = 151,063)	<60 (n = 117,692)	≥60 (n = 33,371)	≥90 (n = 27,117)
Mean (SD)
Inpatient  admissions	0.1 (0.5)	0.1 (0.4)	0.2* (0.6)	0.2* (0.6)	0.3 (0.7)	0.3 (0.6)	0.4* (0.7)	0.4* (0.7)	0.3 (0.9)	0.3 (0.9)	0.4* (1.0)	0.4* (1.0)
Length of stay**	5.8 (10.3)	5.7 (10.1)	6.6* (11.1)	6.6* (11.2)	6.6 (9.8)	6.4 (9.8)	7.0* (10.0)	6.9* (9.6)	8.4 (13.6)	8.1 (13.5)	9.2* (13.7)	9.2* (13.2)
Outpatient  hospital visits	2.7 (2.6)	2.6 (5.8)	3.7* (6.7)	3.6* (6.6)	5.2 (9.7)	5.2 (9.7)	5.4* (9.7)	5.3 (9.6)	4.3 (7.0)	4.1 (6.9)	5.1* (7.0)	5.0* (6.9)
Office visits	10.2 (12.1)	9.8 (11.9)	13.9* (13.0)	13.8* (12.8)	16.0 (14.6)	15.9 (14.6)	16.3* (14.7)	16.2* (14.6)	9.8 (13.2)	9.0 (13.3)	12.5* (12.5)	12.5* (12.2)
Emergency  room visits	0.4 (1.2)	0.4 (1.2)	0.6* (1.7)	0.6* (1.7)	0.6 (1.3)	0.5 (1.2)	0.6* (1.5)	0.6* (1.5)	2.4 (4.5)	2.3 (4.4)	2.5* (4.7)	2.4* (4.5)

*p-value is <0.05 vs <60 days’ supply.

**Among patients with inpatient admissions.

Any HRU event during the 12-month follow-up period.

Baseline days’ supply		Commercial				Medicare				Medicaid
	All (n = 1,698,845)	<60 (n = 1,527,417)	≥60 (n = 171,428)	≥90 (n = 133,203)	All (n = 264,038)	<60 (n = 210,507)	≥60 (n = 53,531)	≥90 (n = 40,191)	All (n = 151,063)	<60 (n = 117,692)	≥60 (n = 33,371)	≥90 (n = 27,117)
Inpatient admissions	8.1%	7.5%	13.2%*	13.0%*	22.9%	21.7%	27.7%*	27.6%*	17.9%	16.9%	21.4%*	21.0%*
Outpatient hospital visits	58.2%	57.0%	69.1%*	68.8%*	73.7%	73.3%	75.3%*	74.9%*	70.0%	67.3%	79.4%*	79.2%*
Office visits	91.7%	91.0%	97.6%*	97.8%*	96.1%	96.1%	96.0%	96.1%	88.0%	86.4%	93.5%*	93.8%*
Emergency room visits	22.1%	21.4%	28.1%*	27.9%*	29.9%	29.0%	33.2%*	33.0%*	60.5%	60.1%	62.1%*	61.8%*

*p-value is <0.05 vs <60 days’ supply.

Number of HRU events during the 12-month follow-up period.

Baseline doses per month		Commercial					Medicare					Medicaid
	All (n = 1,698,845)	≤60 (n = 1,571,747)	>60 (n = 127,098)	≥90 (n = 90,747)	≥120 (n = 53,622)	All (n = 264,038)	≤60 (n = 225,734)	>60 (n = 38,304)	≥90 (n = 26,906)	≥120 (n = 15,677)	All (n = 151,063)	≤60 (n = 127,134)	>60 (n = 23,929)	≥90 (n = 16,928)	≥120 (n = 8857)
Mean (SD)
Inpatient admissions	0.1 (0.5)	0.1 (0.4)	0.2* (0.6)	0.2* (0.6)	0.2* (0.6)	0.3 (0.7)	0.3 (0.6)	0.4* (0.8)	0.4* (0.7)	0.4* (0.8)	0.3 (0.9)	0.3 (0.9)	0.4* (1.1)	0.4* (1.0)	0.4* (1.1)
Length of stay**	5.8 (10.3)	5.7 (10.1)	6.7* (11.3)	6.7* (10.9)	6.9* (11.8)	6.6 (9.8)	6.4 (9.6)	7.3* (10.6)	7.3 (10.5)	7.8* (11.6)	8.4 (13.6)	8.2 (13.4)	9.4* (14.2)	9.3 (13.4)	9.5* (13.3)
Outpatient hospital visits	2.7 (2.6)	2.6 (5.8)	3.7* (6.8)	3.6* (6.6)	3.6* (6.5)	5.2 (9.7)	5.2 (9.8)	5.4* (9.5)	5.3 (9.2)	5.3 (9.0)	4.3 (7.0)	4.1 (6.9)	5.4* (7.3)	5.3* (7.1)	5.4* (7.1)
Office visits	10.2 (12.1)	9.9 (11.9)	14.2* (13.2)	13.9* (12.9)	13.8* (12.8)	16.0 (14.6)	15.9 (14.6)	16.9* (14.9)	16.6* (14.6)	16.5* (14.6)	9.8 (13.2)	9.3 (13.3)	12.7* (12.5)	12.5* (12.4)	12.4* (12.7)
Emergency room	0.4 (1.2)	0.4 (1.2)	0.6* (1.8)	0.6* (1.7)	0.6* (1.8)	0.6 (1.3)	0.5 (1.3)	0.6* (1.4)	0.6* (1.5)	0.6* (1.4)	2.4 (4.5)	2.3 (4.4)	2.6* (4.9)	2.4 (4.4)	2.3 (4.5)

*p-value is <0.05 vs ≤60 doses per month.

**Among patients with any inpatient admissions.

Any HRU event during the 12-month follow-up period.

Baseline doses per month		Commercial					Medicare					Medicaid
	All (n = 1,698,845)	≤60 (n = 1,571,747)	>60 (n = 127,098)	≥90 (n = 90,747)	≥120 (n = 53,622)	All (n = 264,038)	≤60 (n = 225,734)	>60 (n = 38,304)	≥90 (n = 26,906)	≥120 (n = 15,677)	All (n = 151,063)	≤60 (n = 127,134)	>60 (n = 23,929)	≥90 (n = 16,928)	≥120 (n = 8857)
Inpatient admissions	8.1%	7.6%	13.8%*	13.6%*	13.5%*	22.9%	22.0%	28.4%*	27.7%*	27.7%*	17.9%	17.1%	22.3%*	21.8%*	22.1%*
Outpatient hospital visits	58.2%	57.4%	68.8%*	68.1%*	67.7%	73.7%	73.3%	75.9%	75.8%	76.3%	70.0%	68.0%	80.4%*	80.7%*	81.3%*
Office visits	91.7%	91.2%	97.7%	97.8%	97.7%*	96.1%	96.0%	96.7%*	96.8%*	97.0%*	88.0%	86.9%	93.8%*	93.8%*	93.5%*
Emergency room visits	22.1%	21.6%	28.4%*	28.3%*	28.2%*	29.9%	29.3%	33.2%*	32.7%*	32.4%	60.5%	60.1%	63.0%*	61.9%*	61.0%

*p-value is <0.05 vs ≤60 doses per month.

Odds ratio of HRU by baseline days’ supply of IR hydrocodone.

	Days’ supply	Commercial Odds Ratio	Medicare Odds Ratio	Medicaid Odds Ratio
Inpatient admissions	≥60	1.623*	1.448*	0.994
	≥90	1.614*	1.473*	0.974
Outpatient hospital visits	≥60	1.328*	1.124*	1.255*
	≥90	1.313*	1.117*	1.236*
Office visits	≥60	2.584*	0.977	2.336*
	≥90	2.812*	0.998	2.495*
Emergency room visits	≥60	1.479*	1.248*	1.089*
	≥90	1.479*	1.263*	1.078*

*p-value is <0.05 vs <60 days’ supply.

Odds ratio of HRU by baseline doses per month of IR hydrocodone.

	Doses per month	Commercial Odds Ratio	Medicare Odds Ratio	Medicaid Odds Ratio
Inpatient admissions	>60	1.617*	1.467*	1.038*
	≥90	1.620*	1.463*	1.005
	≥120	1.619*	1.485*	1.012
Outpatient hospital visits	>60	1.252*	1.185*	1.302*
	>90	1.228*	1.222*	1.325*
	≥120	1.201*	1.311*	1.361*
Office visits	>60	2.652*	1.217*	2.302*
	≥90	2.745*	1.278*	2.352*
	≥120	2.720*	1.359*	2.270*
Emergency room visits	>60	1.451*	1.219*	1.127*
	≥90	1.458*	1.219*	1.087*
	≥120	1.444*	1.206*	1.053*

*p-value is <0.05 vs ≤60 doses per month.