Trends in healthcare expenditures and resource utilization among a nationally representative population with opioids in the United States: a serial cross-sectional study, 2008 to 2017

One of the most serious public health concerns in recent decades has been the opioid epidemic in the United States (US). Over 9.9 million Americans aged 12 and up abused prescription pain drugs in 2018, and roughly 2 million Americans were diagnosed with opioid use disorder. In 2019, 49,860 drug overdose deaths (70.6 percent of all drug overdose deaths) were caused by opioid use and abuse. The opioid crisis has a huge influence on healthcare expenses and expenditures, in addition to the appalling toll on morbidity and death.

Previous studies on the expenses and expenditures of healthcare for people who are prescribed opioids have mostly focused on those who use opioids on a regular basis or who have an opioid use disorder. However, there are no studies that define the healthcare and spending expenses among a larger number of persons administered opioids in a nationally representative population. From 2008 to 2017, the healthcare expenses and expenditures associated with an opioid-addicted population in the United States are to be defined.

Using pooled data from the Medical Expenditure Panel Survey (MEPS) between 2008 and 2017, a serial cross-sectional design was utilized to assess the economic burden of adult household respondents who were prescribed and not given an opioid. Using propensity score match techniques and survey weights, respondents with an opioid prescription were matched to respondents without an opioid prescription. The survey-weighted yearly healthcare costs and resource use were estimated using two-part generalized linear models that were adjusted for several factors. In addition, 10-year trend comparisons were made between the groups. The prices have been converted to US dollars in 2019. MEPS is a nationally representative sample of the US population that gathers information on how they utilize health services, including prices associated with specific treatments, as curated by the Agency for Healthcare Research and Quality (AHRQ). For a cross-sectional study, the researchers used the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) standards.

After propensity score matching, there were a weighted total of 31,696,671 respondents with an opioid and 31,536,639 respondents without an opioid. The average (SD) age of the sample was 50.63 years (18.03), with 58.9% females and 81.6 percent Whites. RPOs incurred a total yearly economic cost of $524 billion. With and without an opioid, annual total expenditures per responder were $16,542 and $7067, respectively (P 0.001). Similarly, adjusted prescription, outpatient, emergency department, and inpatient costs for respondents who used an opioid were considerably greater than for respondents who did not use an opioid. For overall (+$185; 95 percent CI: $37–$334) and prescription (+$78; 95 percent CI: $28–$128) expenditures, respondents with an opioid had considerably higher average yearly increases than respondents without an opioid. There were no differences in average annual trends for outpatient, emergency department, and inpatient expenses between those who used opioids and those who did not.

The findings show that people who have an opioid prescription spend more money on healthcare and use more resources than those who don't have an opioid prescription. In addition, respondents with more unique opioid prescriptions had higher average yearly total, prescription, and inpatient costs than those with one or two unique opioid prescriptions. The results of this study will inform stakeholders about the financial burden that persons with opioid prescriptions face, which might affect policy, recommendations, and tactics to combat the opioid problem.