Marginal Healthcare Expenditure Burden of Patients With Substance Use Disorder In The United States
Author(s)
Prachet Bhatt, MA1, CHIJIOKE M. OKEKE, BSc2, J. Douglas Thornton, PharmD, PhD2;
1University of Houston, PhD Candidate, Houston, TX, USA, 2University of Houston, Houston, TX, USA
1University of Houston, PhD Candidate, Houston, TX, USA, 2University of Houston, Houston, TX, USA
OBJECTIVES: Substance use disorders (SUD) continue to pose a substantial public health concern in the United States, with overdose deaths increasing in the past few decades. This study aims to estimate the marginal total and out-of-pocket healthcare expenditures associated with SUD treatment among US civilian non-institutionalized adults.
METHODS: This retrospective, cross-sectional study utilized data from the Medical Expenditure Panel Survey (MEPS) and compared adults with and without SUD between 2017 and 2022. Diagnostic codes from the American Psychiatric Association were used to identify patients with alcohol, opioid, tobacco, or other form of SUD. Descriptive weighted analysis was used to examine patient characteristics. Unadjusted mean total and out-of-pocket (OOP) healthcare expenditures were compared between the two groups. A two-part model (TPM) involving logit and a generalized linear model was used to estimate the marginal total and out-of-pocket expenditures of SUD versus non-SUD patients while adjusting for patient characteristics.
RESULTS: The CDC estimates approximately 40 million individuals to have SUD, while this MEPS analysis reported 493 patients representing 0.99 million (95% CI: 0.81-1.2) non-institutionalized adults with some form of SUD diagnosis. The adjusted TPM analysis revealed that compared to non-SUD patients, the marginal total healthcare expenditure for patients diagnosed with SUD was higher ($6,855.11 [95% CI: $5275.43-$8434.79]) with an ambulatory care setting accounting for nearly 36%. Similarly, the estimated marginal OOP healthcare expenditure was $629.20 (95% CI: $430.62-$827.78) higher than non-SUD patients with prescription drug burden accounting for approximately 20% of all OOP expenditures.
CONCLUSIONS: This study found that both the adjusted marginal total and out-of-pocket healthcare expenditures were higher for SUD patients compared to non-SUD patients in the US. These findings highlight the need for actions geared towards addressing the drivers of the high economic burden associated with SUD treatment and also call for the implementation of preventive strategies for mitigating SUD risks.
METHODS: This retrospective, cross-sectional study utilized data from the Medical Expenditure Panel Survey (MEPS) and compared adults with and without SUD between 2017 and 2022. Diagnostic codes from the American Psychiatric Association were used to identify patients with alcohol, opioid, tobacco, or other form of SUD. Descriptive weighted analysis was used to examine patient characteristics. Unadjusted mean total and out-of-pocket (OOP) healthcare expenditures were compared between the two groups. A two-part model (TPM) involving logit and a generalized linear model was used to estimate the marginal total and out-of-pocket expenditures of SUD versus non-SUD patients while adjusting for patient characteristics.
RESULTS: The CDC estimates approximately 40 million individuals to have SUD, while this MEPS analysis reported 493 patients representing 0.99 million (95% CI: 0.81-1.2) non-institutionalized adults with some form of SUD diagnosis. The adjusted TPM analysis revealed that compared to non-SUD patients, the marginal total healthcare expenditure for patients diagnosed with SUD was higher ($6,855.11 [95% CI: $5275.43-$8434.79]) with an ambulatory care setting accounting for nearly 36%. Similarly, the estimated marginal OOP healthcare expenditure was $629.20 (95% CI: $430.62-$827.78) higher than non-SUD patients with prescription drug burden accounting for approximately 20% of all OOP expenditures.
CONCLUSIONS: This study found that both the adjusted marginal total and out-of-pocket healthcare expenditures were higher for SUD patients compared to non-SUD patients in the US. These findings highlight the need for actions geared towards addressing the drivers of the high economic burden associated with SUD treatment and also call for the implementation of preventive strategies for mitigating SUD risks.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE83
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Mental Health (including addition), SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)