An Evaluation of the Prevalence of Diagnosed Opioid Use Disorder and the Economic Burden of Opioid Use Disorder–Related Healthcare Costs in the United States

OBJECTIVES: We sought to characterize the prevalence of diagnosed opioid use disorder (OUD) and define OUD-related healthcare resource utilization (HCRU) and associated costs among patients with acute and chronic pain in the United States (US).

METHODS: Using the Merative™ MarketScan® Commercial Claims and Medicare Supplemental Databases [1/1/2022-12/31/2022 (“study period”)], patients aged ≥18 years who received ≥1 prescription for pain medication were classified as experiencing chronic (≥90 total days’ supply) or acute (<90 total days’ supply) pain. Subgroups with OUD and subgroups with chronic peripheral neuropathic pain (PNP) were identified using International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes. All-cause HCRU, OUD-related HCRU, and associated expenditures were calculated over the study period and extrapolated to US national-level estimates using standardized statistical techniques.

RESULTS: The prevalence of diagnosed OUD was 0.4% among acute pain patients (N = 1,704,808). Among chronic pain patients (N = 1,159,539), the prevalence of diagnosed OUD was 1.9%; the OUD prevalence among the subset of individuals with PNP (N=386,393) was 2.8%. Average annual all-cause per-patient costs were $31,567 and $42,403 for acute and chronic pain patients with OUD, respectively. The highest costs were encountered among chronic PNP patients with OUD ($48,129/patient).

CONCLUSIONS: This study highlights the adverse economic impact of managing pain with current prescription therapies and downstream effects, including OUD. This reality supports the need for novel pain management strategies that can provide effective pain control while mitigating the deleterious consequences of prescription opioid use.