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Wan Y, Corman S, Gao X, et al. Economic burden of opioid-induced constipation among long-term opioid users with noncancer pain. Am Health Drug Benefits. 2015;8(2):93-102
Wan, Y., Corman, S., Gao, X., Liu, S., Patel, H., & Mody, R. (2015). Economic burden of opioid-induced constipation among long-term opioid users with noncancer pain. American health & drug benefits, 8(2), 93-102.
Wan, Yin, et al. "Economic burden of opioid-induced constipation among long-term opioid users with noncancer pain." American health & drug benefits vol. 8,2 (2015): 93-102.
Wan Y, Corman S, Gao X, Liu S, Patel H, Mody R. Economic burden of opioid-induced constipation among long-term opioid users with noncancer pain. Am Health Drug Benefits. 2015 Apr;8(2):93-102. PMID: 26005516; PMCID: PMC4437482.
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Am Health Drug Benefits. 2015 Apr;8(2):93-102.

Economic burden of opioid-induced constipation among long-term opioid users with noncancer pain.

American health & drug benefits

Yin Wan, Shelby Corman, Xin Gao, Sizhu Liu, Haridarshan Patel, Reema Mody

Affiliations

  1. Associate Scientist, Pharmerit International, Bethesda, MD.
  2. Senior Clinical Outcomes Scientist, Pharmerit International, Bethesda, MD.
  3. Senior Director, Pharmerit International, Bethesda, MD.
  4. Outcomes Research Analyst, Pharmerit International, Bethesda, MD.
  5. Fellow in Global Outcomes Research, Takeda Pharmaceuticals International, Inc, Deerfield, and Consultant, Immensity Consulting, Inc, Chicago, IL.
  6. Associate Director, Outcomes Research, Takeda Pharmaceuticals International, Inc, Deerfield, IL.

PMID: 26005516 PMCID: PMC4437482

Abstract

BACKGROUND: Opioid-induced constipation (OIC) can be a debilitating side effect of opioid therapy and may result in increased medical costs. The published data on the economic burden of OIC among long-term opioid users are limited.

OBJECTIVE: To assess the economic burden of OIC in patients with noncancer pain in a managed care population in the United States.

METHODS: This retrospective study used 2007-2011 data from the Truven Health MarketScan Commercial and Medicare databases. The study included adults with ≥12 months of insurance enrollment before and after starting long-term (≥90 days) use of opioids. Patients were excluded if they had cancer or a diagnosis of drug abuse or drug dependence during the study period, or if they had constipation or bowel obstruction within 90 days before starting opioid therapy during the study period. OIC was identified by International Classification of Diseases, Ninth Edition codes for constipation (564.0) or bowel obstruction (560.x) within 12 months of the initiation of an opioid. Patients with OIC were identified in the nonelderly, elderly (age ≥65 years), and long-term care populations. Differences in costs and healthcare resource utilization were calculated using propensity scoring.

RESULTS: A total of 13,808 nonelderly (age, 48.6 ± 10.4 years; female, 50%) and 2958 elderly patients (age, 78.7 ± 8.1 years; female, 70%) met the study inclusion criteria. Of 401 nonelderly and 194 elderly patients with OIC, 85 patients initiated opioid therapy in a long-term care facility (age, 80.7 ± 11.6 years; female, 77%). After matching by key covariates, patients with OIC had significantly more hospital admissions than patients without OIC (nonelderly, 33% vs 22%, respectively; P <.001; elderly, 51% vs 31%, respectively; P <.001) and longer inpatient stays (nonelderly, 3.0 ± 8.4 days vs 1.0 ± 3.0 days, respectively; P <.001; elderly, 5.2 ± 12.2 days vs 2.1 ± 4.0 days, respectively; P <.001). The group with OIC had significantly higher total healthcare costs than the group without OIC in all 3 study cohorts (nonelderly, $23,631 ± $67,209 vs $12,652 ± $19,717, respectively; elderly, $16,923 ± $38,191 vs $11,117 ± $19,525, respectively; long-term care, $16,000 ± $22,897 vs $14,437 ± $25,690, respectively; all P <.05).

CONCLUSION: To the best of our knowledge, this is the first study to analyze the economic impact of long-term use of opioids among patients with OIC, using real-world data. The findings underscore the significant economic burden associated with long-term opioid use for noncancer pain in a managed care population. Effective therapies for OIC may reduce the associated economic burden and improve quality of life for long-term opioid users.

Keywords: constipation; economic burden; elderly; healthcare resource utilization; long-term care; long-term opioid use; opioid-induced constipation; pain management

References

  1. J Pain Symptom Manage. 2010 Nov;40(5):696-703 - PubMed
  2. Ann Pharmacother. 2010 Apr;44(4):630-40 - PubMed
  3. J Pain Palliat Care Pharmacother. 2009;23(3):231-41 - PubMed
  4. Cancer Control. 2004 May-Jun;11(3 Suppl):3-9 - PubMed
  5. Am Health Drug Benefits. 2015 Apr;8(2):93-102 - PubMed
  6. Pain Physician. 2008 Mar;11(2 Suppl):S181-200 - PubMed
  7. Value Health. 2011 Jul-Aug;14(5 Suppl 1):S78-81 - PubMed
  8. South Med J. 2004 Feb;97(2):129-34 - PubMed
  9. Pharmacotherapy. 2013 Apr;33(4):383-91 - PubMed
  10. Am J Geriatr Pharmacother. 2007 Jun;5(2):129-36 - PubMed
  11. Pain. 2008 Aug 31;138(2):440-9 - PubMed
  12. Arthritis Res Ther. 2005;7(5):R1046-51 - PubMed
  13. Manag Care. 2010 Mar;19(3):44-51 - PubMed
  14. Int J Clin Pract. 2007 Jul;61(7):1181-7 - PubMed
  15. Pain Med. 2009 Jan;10(1):35-42 - PubMed
  16. Pain. 2004 Jun;109(3):514-9 - PubMed

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