Trends in Medical Expenditure and Resource Utilization Among Opioid, Benzodiazepine, Skeletal Muscle Relaxant, and Gabapentin Users: A Pooled Cross Sectional Analysis from 2009 - 2019

Author(s)

Sepassi A1, Li M2, Suh K3, Stottlemyer B3, Bounthavong M4
1University of California, Irvine, Carlsbad, CA, USA, 2University of Texas MD Anderson Cancer Center, Houston, TX, USA, 3University of Pittsburgh, Pittsburgh, PA, USA, 4University of California-San Diego, La Jolla, CA, USA

Presentation Documents

OBJECTIVES:

To evaluate health expenditure and emergency department use associated with non-opioid analgesic, opioid-only, opioid+benzodiazepine (OP/BZD), opioid+benzodiazepine+skeletal muscle relaxant (OP/BZD/SMR), and opioid+gabapentin (OP/GABA) users in the US from 2009-2019.

METHODS:

We performed a pooled serial cross-sectional analysis using nationally representative data from 2009-2019 of the Medical Expenditure Panel Survey. We evaluated differences in annual healthcare expenditures (total, inpatient, outpatient, emergency department, prescription) and ED utilization between users reporting non-opioid analgesics only, opioids only, OPI/BZD, OPI/BZD/SMR, and OP/GABA. A generalized linear model with a gamma distribution and interaction terms between treatment group and year was fitted to estimate differences in yearly changes in expenditure across treatment groups. We used survey weights to derive nationally representative estimates.

RESULTS:

A weighted total of 163,892,872 non-opioid users, 175,076,188 opioid-only users, 19,826,350 OP/BZD users, 4,815,304 OP/BZD/SMR users, 13,049,509 OP/GABA users were included in our sample. Compared to non-opioid analgesic users, OP/GABA users had the greatest adjusted annual expenditures (RR=2.99, 95%CI:2.60-3.11) and the highest annual increase in average total expenditure per year compared to non-opioid users (coefficient=$1,231.41, 95%CI:$492.50-$1,970.33). OP/BZD/SMR users had higher rates of ED utilization compared to non-opioid users (RR=2.60,95%CI:1.64-2.60).

CONCLUSIONS:

OP/GABA users had higher healthcare expenditure and rates of expenditure increase over time compared to non-narcotic users from 2009-2019. OP/BZR/SMR users had higher rates of ED use compared to non-narcotic users. These results may inform health policy initiatives that seek to reduce unnecessary opioid use in patients using other medications associated with opioid misuse.

Conference/Value in Health Info

2023-05, ISPOR 2023, Boston, MA, USA

Value in Health, Volume 26, Issue 6, S2 (June 2023)

Code

EE315

Topic

Economic Evaluation

Disease

Drugs, Mental Health (including addition), Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Neurological Disorders

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