OBJECTIVES

There is urgent need to understand the costs associated with opioid use among pregnant women. This study examined factors associated with opioid use during pregnancy, and estimated the incremental total medical expenditures of opioid users as compared to that of non-users from U.S. payers’ perspective.

METHODS

This retrospective, cross-sectional study compared the average annual total medical expenditures between adult (aged 18~44) pregnant women with at least one opioid prescription during survey rounds (26.1%, N = 901) and those counterparts without opioid prescription (73.9%, N = 2553) using data from the 2011~2015 Medical Expenditure Panel Survey (MEPS). The incremental total annual healthcare expenditures as well as charges by category (inpatient, outpatient, emergency, prescription, and other services) were estimated. All expenditures were adjusted to 2015 U.S. dollars. Generalized linear regression model was used to estimate costs, adjusting for sociodemographic characteristics, health status, and chronic conditions. All analyses accounted for complex survey design.

RESULTS

Among the 3,454 unweighted observations, pregnant opioid users had nearly 1.9 times greater unadjusted average annual total healthcare expenditures ($13,370; 95% CI: $12,054-14,686) as compared to those without opioid prescription ($7,302; 95% CI: $6,748-7,857). The incremental cost of using opioids during pregnancy was mainly come from inpatient stays (opioid users: $8,054; 95% CI: $7,193-8,915 vs. non-users: $4,197; 95% CI: $3,736-4,659). After adjusting for covariates, significant higher average annual total medical expenditures persisted for pregnant women with opioid prescription ($13,409; 95% CI $12,355-$14,464 vs. $7174; 95% CI $6,687-$7.659; p<0.0001).

CONCLUSIONS

A significant incremental economic burden among pregnant opioid users was found in the pooled sample, compared to those without opioid prescription. Understanding the medical utilization pattern helps healthcare providers and policy makers tailor treatment and educational programs for target populations which in turn may, relieve economic burden of opioid epidemic among pregnant women on society.