Economic Burden of Opioid-Induced Constipation Among Patients With or Without Cancer in the United States
Author(s)
Adam Laitman, MD1, Patrick Gagnon-Sanschagrin, MSc2, Rebecca Bungay, MScPH2, Remi Bellefleur, MA2, Nathan Gobeil, MSc2, Annie Guerin, MSc2, Shweta Kiran Shah, PhD3, Olamide Olujohungbe, PharmD3, Aaron Samson, PharmD3.
1Salix Pharmaceuticals, Bridgewater, NJ, USA, 2Analysis Group, Inc., Montréal, QC, Canada, 3Bausch Health, Bridgewater, NJ, USA.
1Salix Pharmaceuticals, Bridgewater, NJ, USA, 2Analysis Group, Inc., Montréal, QC, Canada, 3Bausch Health, Bridgewater, NJ, USA.
Presentation Documents
OBJECTIVES: To compare healthcare costs between commercially insured continuous opioid users with/without opioid-induced constipation (OIC) in the United States (US), separately among patients with/without cancer.
METHODS: Adults with ≥90 days continuous opioid use were identified using Komodo Research Data (01/2016-02/2024) and stratified into OIC and No OIC cohorts based on presence of an OIC indicator (constipation diagnosis or treatment). For the OIC cohort, index date was defined as the first OIC indicator during continuous opioid use; for the No OIC cohort (without an indicator), it was randomly selected during continuous opioid use to match the OIC cohort’s duration of opioid use pre-index. Patients with a diagnosis of cancer in the 3-month continuously-enrolled pre-index period were classified as having cancer, and those without were classified as not having cancer. OIC and No OIC patient characteristics were entropy-balanced separately among patients with/without cancer. All-cause healthcare costs per-patient-per-year (2024 USD) were measured in the 6-month continuously-enrolled post-index period and compared between OIC and No OIC cohorts for patients with/without cancer, separately, using weighted generalized linear models with log link and gamma distribution.
RESULTS: After reweighting, patient characteristics were similar between cohorts in patients with cancer (OIC: N=49,286; No OIC: N=71,318) and without cancer (OIC: N=281,142; No OIC: N=943,112). Among patients with cancer, total healthcare costs were significantly higher in the OIC than No OIC cohort (difference=$78,358), including medical (difference=$73,247) and pharmacy costs (difference=$5,112; all p<0.001). Similarly, among patients without cancer, total healthcare costs were significantly higher in the OIC than No OIC cohort (difference=$33,604), including medical (difference=$31,375) and pharmacy costs (difference=$2,230; all p<0.001).
CONCLUSIONS: In this real-world analysis of continuous opioid users in the US, OIC was associated with a significant economic burden in the management of both cancer-related and non-cancer related pain. Targeted treatment for OIC among long-term opioids users could help alleviate this burden.
METHODS: Adults with ≥90 days continuous opioid use were identified using Komodo Research Data (01/2016-02/2024) and stratified into OIC and No OIC cohorts based on presence of an OIC indicator (constipation diagnosis or treatment). For the OIC cohort, index date was defined as the first OIC indicator during continuous opioid use; for the No OIC cohort (without an indicator), it was randomly selected during continuous opioid use to match the OIC cohort’s duration of opioid use pre-index. Patients with a diagnosis of cancer in the 3-month continuously-enrolled pre-index period were classified as having cancer, and those without were classified as not having cancer. OIC and No OIC patient characteristics were entropy-balanced separately among patients with/without cancer. All-cause healthcare costs per-patient-per-year (2024 USD) were measured in the 6-month continuously-enrolled post-index period and compared between OIC and No OIC cohorts for patients with/without cancer, separately, using weighted generalized linear models with log link and gamma distribution.
RESULTS: After reweighting, patient characteristics were similar between cohorts in patients with cancer (OIC: N=49,286; No OIC: N=71,318) and without cancer (OIC: N=281,142; No OIC: N=943,112). Among patients with cancer, total healthcare costs were significantly higher in the OIC than No OIC cohort (difference=$78,358), including medical (difference=$73,247) and pharmacy costs (difference=$5,112; all p<0.001). Similarly, among patients without cancer, total healthcare costs were significantly higher in the OIC than No OIC cohort (difference=$33,604), including medical (difference=$31,375) and pharmacy costs (difference=$2,230; all p<0.001).
CONCLUSIONS: In this real-world analysis of continuous opioid users in the US, OIC was associated with a significant economic burden in the management of both cancer-related and non-cancer related pain. Targeted treatment for OIC among long-term opioids users could help alleviate this burden.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE319
Topic
Economic Evaluation
Disease
SDC: Gastrointestinal Disorders