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Area of Science:

  • Health Economics
  • Pharmacoepidemiology
  • Real-World Evidence

Background:

  • Opioid use is a significant public health concern.
  • Understanding the economic impact of transitioning to chronic opioid therapy (COT) is critical for healthcare payers.
  • Healthcare utilization and expenditure trajectories following incident opioid use require detailed analysis.

Purpose of the Study:

  • To evaluate the association between the transition from incident opioid use to chronic opioid therapy (COT).
  • To analyze the impact on healthcare utilization and expenditures.
  • To identify key periods for intervention by healthcare payers.

Main Methods:

  • Retrospective cohort study using a commercial claims database (2006-2015).
  • Inclusion of 20,201 adults aged 28-63 without cancer.
  • Analysis of seven 120-day periods (preindex, index, postindex) using multivariable models for utilization and expenditures.

Main Results:

  • Patients on chronic opioid therapy (COT) showed higher likelihood of inpatient service use (aOR, 1.11).
  • Expenditures peaked during the index period for all users.
  • Significant differences in total and inpatient expenditures were observed between COT and non-COT users, with highest disparities during the index period.

Conclusions:

  • The transition phase from initial opioid prescription to chronic opioid therapy (COT) presents a critical window for intervention.
  • Payers can optimize resource allocation by targeting this pre-COT period.
  • Early intervention strategies may mitigate long-term healthcare costs associated with chronic opioid use.