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The Burden of Undiagnosed Opioid Abuse Among Commercially Insured Individuals.
Pain Med. 2015 Jul; 16(7):1325-32.PM

Abstract

OBJECTIVES

Estimate the prevalence and healthcare costs of undiagnosed opioid abuse among commercially insured individuals.

STUDY DESIGN

Retrospective analysis of de-identified pharmacy and medical claims data and publicly-available survey data (no IRB approval required).

METHODS

This study focused on commercially insured individuals. Rates of prescription pain-reliever abuse/dependence ("abuse") among individuals ages ≥12 were calculated using National Survey on Drug Use and Health (NSDUH) public-use data for 2006-2011 and assumed to capture both diagnosed and undiagnosed opioid abuse. Rates of undiagnosed opioid abuse were calculated as the difference between NSDUH rates and published rates of diagnosed opioid abuse. OptumHealth Reporting and Insights claims data were used to estimate the healthcare costs of undiagnosed abuse. Diagnosed abusers ages 12-64 were identified using ICD-9-CM diagnosis codes for opioid abuse/dependence. Pre-diagnosis costs were assumed to be a proxy for undiagnosed opioid abuse costs. The ratio of undiagnosed to diagnosed abuse costs was calculated as the ratio of annual per-patient healthcare costs between pre-diagnosis and post-diagnosis periods.

RESULTS

While rates of diagnosed opioid abuse among commercially insured individuals increased from 0.07% in 2006 to 0.19% in 2011, rates of undiagnosed abuse decreased from 0.42% to 0.38% over the same time period. Annual per-patient healthcare costs of undiagnosed abusers were 69.2% of those of diagnosed abusers.

CONCLUSIONS

Per-patient healthcare costs of undiagnosed abusers among the commercially insured are estimated to be lower than those of diagnosed abusers. However, the higher prevalence of undiagnosed opioid abuse implies that undiagnosed abuse represents a substantial burden to commercial payers.

Authors+Show Affiliations

Analysis Group, Inc., Boston, Massachusetts.Analysis Group, Inc., Boston, Massachusetts.Analysis Group, Inc., Boston, Massachusetts.Analysis Group, Inc., Boston, Massachusetts.Analysis Group, Inc., Boston, Massachusetts.Analysis Group, Inc., Boston, Massachusetts.Purdue Pharma L.P., Stamford, Connecticut, USA.Purdue Pharma L.P., Stamford, Connecticut, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25929289

Citation

Kirson, Noam Y., et al. "The Burden of Undiagnosed Opioid Abuse Among Commercially Insured Individuals." Pain Medicine (Malden, Mass.), vol. 16, no. 7, 2015, pp. 1325-32.
Kirson NY, Shei A, Rice JB, et al. The Burden of Undiagnosed Opioid Abuse Among Commercially Insured Individuals. Pain Med. 2015;16(7):1325-32.
Kirson, N. Y., Shei, A., Rice, J. B., Enloe, C. J., Bodnar, K., Birnbaum, H. G., Holly, P., & Ben-Joseph, R. (2015). The Burden of Undiagnosed Opioid Abuse Among Commercially Insured Individuals. Pain Medicine (Malden, Mass.), 16(7), 1325-32. https://doi.org/10.1111/pme.12768
Kirson NY, et al. The Burden of Undiagnosed Opioid Abuse Among Commercially Insured Individuals. Pain Med. 2015;16(7):1325-32. PubMed PMID: 25929289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Burden of Undiagnosed Opioid Abuse Among Commercially Insured Individuals. AU - Kirson,Noam Y, AU - Shei,Amie, AU - Rice,J Bradford, AU - Enloe,Caroline J, AU - Bodnar,Katharine, AU - Birnbaum,Howard G, AU - Holly,Pamela, AU - Ben-Joseph,Rami, Y1 - 2015/04/30/ PY - 2014/12/18/received PY - 2015/03/09/revised PY - 2015/03/25/accepted PY - 2015/5/2/entrez PY - 2015/5/2/pubmed PY - 2016/5/3/medline KW - Costs KW - Prevalence KW - Undiagnosed Opioid Abuse SP - 1325 EP - 32 JF - Pain medicine (Malden, Mass.) JO - Pain Med VL - 16 IS - 7 N2 - OBJECTIVES: Estimate the prevalence and healthcare costs of undiagnosed opioid abuse among commercially insured individuals. STUDY DESIGN: Retrospective analysis of de-identified pharmacy and medical claims data and publicly-available survey data (no IRB approval required). METHODS: This study focused on commercially insured individuals. Rates of prescription pain-reliever abuse/dependence ("abuse") among individuals ages ≥12 were calculated using National Survey on Drug Use and Health (NSDUH) public-use data for 2006-2011 and assumed to capture both diagnosed and undiagnosed opioid abuse. Rates of undiagnosed opioid abuse were calculated as the difference between NSDUH rates and published rates of diagnosed opioid abuse. OptumHealth Reporting and Insights claims data were used to estimate the healthcare costs of undiagnosed abuse. Diagnosed abusers ages 12-64 were identified using ICD-9-CM diagnosis codes for opioid abuse/dependence. Pre-diagnosis costs were assumed to be a proxy for undiagnosed opioid abuse costs. The ratio of undiagnosed to diagnosed abuse costs was calculated as the ratio of annual per-patient healthcare costs between pre-diagnosis and post-diagnosis periods. RESULTS: While rates of diagnosed opioid abuse among commercially insured individuals increased from 0.07% in 2006 to 0.19% in 2011, rates of undiagnosed abuse decreased from 0.42% to 0.38% over the same time period. Annual per-patient healthcare costs of undiagnosed abusers were 69.2% of those of diagnosed abusers. CONCLUSIONS: Per-patient healthcare costs of undiagnosed abusers among the commercially insured are estimated to be lower than those of diagnosed abusers. However, the higher prevalence of undiagnosed opioid abuse implies that undiagnosed abuse represents a substantial burden to commercial payers. SN - 1526-4637 UR - https://www.unboundmedicine.com/medline/citation/25929289/The_Burden_of_Undiagnosed_Opioid_Abuse_Among_Commercially_Insured_Individuals_ L2 - https://academic.oup.com/painmedicine/article-lookup/doi/10.1111/pme.12768 DB - PRIME DP - Unbound Medicine ER -