OBJECTIVES : Misuse and abuse of prescription opioids is a serious and costly public health concern affecting many sectors of society, but its effects also carry into the workplace. The objective of this analysis is to compare work loss and costs associated with opioid abuse from the perspective of employers.

METHODS : A retrospective analysis of OptumHealth Care Solutions database was conducted. Continuously enrolled employer-based health plan members (12-64 years of age) with work loss data and at least one medical claim for opioid abuse/dependence (ICD-9 codes 3040x, 3047x, 3055x, 96500, 96502, 96509) between Q1 2013 and Q3 2015 (index date) were matched with randomly selected but similar comparison health plan members having no medical claim for opioid abuse/dependence or heroin abuse (ICD-9 code 96501). Cohorts were propensity matched on baseline demographic/clinical characteristics and healthcare utilization/costs (n=2,311 per cohort). Members were followed up 12 months after the index date to assess number of disability days (when benefits were received) and medically-related absenteeism days (missed work due to a medical event). Each work-loss day was assumed to generate employer costs equal to the average daily wage for plan members, inflated to USD2016.

RESULTS : Medical claims associated with opioid abuse/dependence occurred in 0.17% of this sample. Members with medical claims for opioid abuse/dependence had higher healthcare resource use and incidence of certain comorbidities (e.g., Hepatitis C: 3.0% v. 0.7%; p<0.001) compared to those with no abuse/dependence claims. This was associated with greater disability (mean days: 9.5 vs. 5.6; p<0.001) and medically-related absenteeism for abusers (mean days: 18.0 versus 10.2; p<0.001) relative to the comparison group, resulting in cost estimates of $8,580 per abuser compared with $5,878 per non-abusers.

CONCLUSIONS : Results from this analysis suggest that opioid abuse and dependence was associated with significant work productivity loss and may pose a considerable cost to employers.