Evaluation of Medical Expenditure Associated with Opioid Usage in Chronic Non-Cancer Pain

Abstract

In the United States, as of 2016 there were around 28 million individuals with chronic non-cancer pain (CNCP) conditions. If uncontrolled, CNCP can have enormous economic, societal and health consequences. Currently, a common treatment for CNCP is long-term opioid therapy. If used properly, opioid treatment can relieve pain and increase quality of life with manageable adverse effects. However, opioid treatment is controversial due to the health and economic burden from the potential for addiction and other serious adverse effects, and from the prevalence of diversion of opioids to nontherapeutic uses. This retrospective study estimates the impact of pain management with and without opioids on medical expenditures for CNCP conditions. The data sources are 12-years Medical Expenditure Panel Survey (MEPS) data and 5-years commercial claims data from Blue Cross Blue Shield of Texas (BCBSTX). Two analytic approaches were applied to both data sets: 1) cross-sectional descriptive analysis and regression models to evaluate differences in service utilization and expenditure among CNCP patients with and without opioid treatment; and 2) longitudinal analysis to examine changes in health outcomes and expenditures for before and after new episodes of opioid treatment for CNCP patients. Results from analyses of both datasets indicated higher CNCP treatment costs associated with opioid treatment.