OBJECTIVES

To examine the status of opioid abuse and medical costs among patients prescribed opioids using the national health insurance claims data

METHODS

We conducted a retrospective cohort study using the National Health Insurance Service Sample Cohort database. We identified patients prescribed ≥1 outpatient opioids between 2013 and 2015 and without any cancer diagnosis (except non-melanoma skin cancer) between 2012 and 2015. Patients were regarded as opioid abusers if they satisfy one of the following conditions: i) ≥4 prescribers for opioid prescriptions during a 90-day period; ii) two prescriptions of the same opioid overlapped by ≥25% of the total supply. Chronic opioid users were defined as patients provided opioids >90 days without gaps of ≥32 days. The definition of abuse and chronic use were based on published studies. Patient characteristics, proportion of opioid abusers, total annual healthcare costs, annual opioid costs, and healthcare resource use were assessed.

RESULTS

Among 258,953 patients prescribed opioids between 2013 and 2015 (mean age 49.4 years and 53% of female), 6.3% was chronic users. The proportion of opioid abusers was 5.0% in total population and higher in chronic users than non-chronic users (43.2% vs. 2.5%). For the type of abuse, opioid overlap (93.3%) was more frequent than multiple prescribers (13.6%) and 6.9% of abusers had both types of abuse. Total annual healthcare cost and annual opioid cost were higher in opioid abusers than non-abusers (2283 USD vs. 877 USD and 46 USD vs. 4 USD in 2015, respectively). Length of stay and number of hospital visits were also higher in opioid abusers than non-abusers (10.5 days vs. 3.3 days and 42 vs. 19 in 2015, respectively).

CONCLUSIONS

Opioid abuse was presented in patients treated with opioids, especially in chronic users, with increased medical costs. Prevention strategies are needed to cope with the burden of opioid abuse.