Jeffrey Vietri,1 Elizabeth T Masters,2 Alexandra I Barsdorf,2 Jack Mardekian3 1Health Outcomes Practice, Kantar Health, Horsham, PA, USA; 2Health Economics & Outcomes Research, copyright Inc., New York, NY, USA; 3Statistical Research & Data Science Center, copyright SACS Inc., New York, NY, USA Objective: To provide per-patient estimates of the economic burden for opioid medication abuse with and without tampering.Patients and methods: Adults in the US who participated in the 2010 and/or 2011 National Health and Wellness Survey were resurveyed to provide information on use and abuse of prescription opioids in the previous 3 months.
Participants (N=20,885) were categorized as those who abused and tampered (n=107), abused without tampering (n=118), those who reported using of opioids as prescribed (n=981), and non-opioid controls (n=19,679).Average wages from the Bureau of Labor Statistics and health care unit costs from the Truven MarketScan database were applied to self-reported work impairment (absenteeism, presenteeism, and overall work impairment) and health care resource utilization (health care provider visits, emergency room visits, hospitalizations, and drug rehabilitation) to estimate indirect N-Acetyl D-Glucosamine and direct medical costs, respectively.Estimated mean costs for these groups were compared using analysis of variance, and generalized linear models were used to compare costs adjusted for confounders.Results: Those who abused and tampered had significantly higher mean indirect (work impairment: $3,614 vs $2,938, p<0.
05) and direct (health care use: $23,328 vs $4,514, p<0.001) costs over 3 months than those who abused without tampering.This included higher mean incremental costs for non-opioid-related medical visits ($14,180 vs $2,236, p<0.001), opioid-related medical visits ($8,790 vs $2,223, p<0.
001), and drug rehabilitation ($358 vs $55, p<0.001).Increased total direct costs were associated with tampering after adjusting for confounders (p<0.001).
Median incremental costs were also higher among those who tampered.Conclusion: Tampering with prescription opioid medications is associated with significantly increased medical costs compared to abuse without tampering.Reducing tampering may provide net health care savings.Keywords: direct costs, health care resource utilization, indirect costs, medication tampering, opioid abuse, work impairment, abuse deterrent .