Trends of Per-Patient Healthcare Cost and Resource Utilization of Opioid Use Disorder Among Privately Insured Individuals in The United States from 2005-2014

Author(s): Bibo Jiang, Li Wang, Douglas Leslie

Background: Total healthcare cost and resource utilization associated with treatment for opioid use disorder (OUD) has increased drastically in the past twenty years as the opioid epidemic continues to escalate. However, little is known about the changes in per-patient healthcare cost and resource utilization of OUD over time.

Objectives: To investigate the trends of per-patient healthcare cost and utilization of outpatient, inpatient and emergency department services among privately insured individuals with OUD from 2005 to 2014.

Methods: The MarketScan® Commercial Claims and Encounters database was used. A matched case-control design was employed to estimate the impact of OUD on healthcare cost and service utilization over this period. In particular, we investigated the trends of excess per-patient healthcare cost and its components including inpatient, outpatient and drug costs. We also compared the utilization of outpatient, inpatient and emergency department services between OUD patients and non-OUD control subjects.

Main findings: The excess annual per-patient healthcare cost for OUD remained relatively stable with an average excess cost of $14,586 between 2005 and 2014. However, excess outpatient costs increased while excess inpatient costs decreased over time. Among OUD patients, the increase in the OUD-related outpatient care utilization rates and the average number of visits coincided with a decrease in inpatient and emergency department (ED) service utilization rates and average number of ED visits.

Conclusions: The increasing per-patient utilization of OUD-related outpatient care, together with a decline in the per-patient utilization of more urgent care, including inpatient and emergency department care, might suggest an increased awareness, diagnosis and better management of the disease among existing patients with private insurance. Efforts focused on increasing access to OUD treatment are crucial in combating the opioid epidemic.