The High Cost of Opioid Abuse
Posted on October 21, 2011The Wall Street Journal recently reported the findings from a study which assigned hard numbers to the country’s epidemic of prescription drug abuse and the issue of chronic pain management. According to the article, those two problems combine to cost taxpayers, employers and insurers upwards of $323 billion each year.
The study was a joint effort of Laffler Associates, an economic research firm, and Millennium Research Institute and is titled, "An Economic Analysis of the Costs and Benefits Associated with Regular Urine Drug Testing for Chronic Pain Patients in the United States." The study demonstrates how research-based medical practices could improve patient outcomes and create significant cost savings.
A few statements of fact may help set the stage for the importance of a cost-benefit study. In July 2011, the Institute of Medicine issued a report in which it said that greater than 116 million U.S. citizens struggle with chronic pain. That medical condition alone costs $635 billion in this country, with a significant percentage of the cost relating to misuses and abuses of opioid drugs. Between 2004 and 2008, emergency room visits associated with opioid abuse increased more than two times. The use of opioids in medical treatment has risen tenfold since 1990.
Laffler Associates accessed the Millennium Research database to perform its independent study of urine drug test results from more than 260,000 test profiles stretching over the period of one year. The study team employed Logistic Regression methodology to develop its probability curve for determining how urine drug testing would impact prescription adherence. Adherence was defined as a patient taking their medication just as ordered and not supplementing their prescription with other medications or with illicit drugs.
The "data demonstrates a clear correlation between increased UDT and the probability that patients will adhere to their medications," said the principal investigator in the study. When six UDT were assigned, a notable increase occurred in the likelihood of adherence. At the same time, a 35 percent reduction in the non-adherence rate could be expected.
The study’s cost-benefit analysis determined a $7 billion to $25 billion net benefit when two to six UDTs were administered. Conducting in-office screenings combined with laboratory urine drug testing could produce a net benefit that was three times the cost of the testing.
In short, regular UDT delivers significant net economic benefit while also producing positive health management value. The research results pointed to how evidenced-based healthcare can benefit the patient and lower costs. The findings were so significant that the team has decided to do further study in partnership with universities.
The nation must find a way to cut 1.2 trillion dollars in over-spending by January 2012. The Laffler/Millenium study shows that it is possible to realize cuts while improving care at the same time. The research gives strong evidence to back up its suggested change of more widespread urine drug testing. At the same time, the study lays out the significant problem of chronic pain in the U.S. While doctors need to treat chronic pain patients, including prescribing them opioid medications, increased urine drug testing ensures that the practice is handled responsibly. The result is quantifiable savings for our healthcare system and for U.S. taxpayers.
