Reigning in costs is a key component of healthcare reform. So it is clear why it will be essential for both providers and policy makers to identify
those most at risk for driving up costs.
According to a recent study published in The American Journal of Managed Care
), opioid analgesic–treated chronic pain (OAT-CP) patients who showed signs of trouble cost their health plan an estimated $12,877 a year. Precursors of trouble ranged from rapid dose escalation to doctor shopping.
“More than one-third of a sample of OAT-CP patients were identified as potentially problematic opioid users according to the study definitions applied. Healthcare service utilization and expenditures were significantly greater for this group compared with the control group,” reported the study authors.
According to an official press release
on the findings:
Of the patients in the study, 39% showed signs of problematic behavior, which included doctor shopping (defined as receiving fills from 5 or more prescribers in a year) and rapid dose escalation (defined as either a 50% increase in opioid dose in the first 3 months or a 100% increase in the follow-up period). Compared with the control group, this group had:
Higher pharmacy costs ($6573 compared with $6160)
Higher office visit costs ($5705 compared with $4470)
Higher emergency department costs ($835 compared with $388)
Higher inpatient costs ($15,646 compared with $7445)
Higher total healthcare costs ($39,048 compared with $26,171)
However, proper caution and monitoring can reduce risk of opioid misuse or adverse outcomes.
“[There are] a number of tools and approaches clinicians should use to safely prescribe opioids,” the study said. “These include checking prescription drug monitoring programs, which track information on controlled substance prescriptions filled in a state, taking a careful history of substance abuse and other mental health problems, conducting routine urine drug screens in concert with pain management agreements, and making use of pain medicine consultants when problems arise.”
Read the full study here
Around the Web
AJMC: Recognizing Certain Indicators Can Prevent Opioid Misuse and Overdose [AJMC]
Study: Pain Patients Who Show Signs of Trouble Cost Health Plan an Extra $12,877 a Year [AJMC]