title: Opioid analgesic-treated chronic pain patients at risk for problematic use.
abstract: OBJECTIVE
  To characterize potentially problematic opioid use (PPOU) among opioid analgesic-treated chronic pain (OAT-CP) patients and to compare their healthcare service utilization and expenditures with those of a control group of OAT-CP patients not exhibiting these behaviors.
  
  
  METHODS
  Cross-sectional, retrospective analysis of health claims data.
  
  
  METHODS
  Members of a national health plan (n = 3891) with chronic pain and an opioid prescription were categorized into 3 groups: PPOU group (n = 1499), those displaying evidence of doctor shopping or rapid opioid dose escalation; buprenorphine/naloxone group (n =199), those who filled a prescription for buprenorphine/naloxone, which served as a proxy for opioid dependence; and control group (n = 2193), those not meeting either of the above criteria. Groups were compared on 1-year healthcare service utilization and costs.
  
  
  RESULTS
  The PPOU group made up more than one-third of the study sample. Compared with the control group, they incurred significantly greater 1-year adjusted mean pharmacy costs ($6573 vs $6160), office costs ($5705 vs $4479), emergency department (ED) costs ($835 vs $388), inpatient costs ($15,646 vs $7445), and total healthcare costs ($39,048 vs $26,171) (all P <.05). The buprenorphine/naloxone group incurred significantly greater 1-year pharmacy costs ($6981 vs $6160) and ED costs ($1126 vs $388) (both P <.05) than the control group.
  
  
  CONCLUSIONS
  The PPOU group had the highest healthcare service utilization and costs. Although drivers of elevated service utilization and cost among this population are not clear, health plans may want to focus on PPOU case identification and development of interventions.
authors: 9200 Rumsey Rd, Ste 215, Columbia, MD 21045. E-mail: joseph.tkacz@healthanalytic.com.
authors: Joseph
authors: J
authors: Tkacz
authors: Jacqueline
authors: J
authors: Pesa
authors: Lien
authors: L
authors: Vo
authors: Peter G
authors: PG
authors: Kardel
authors: Hyong
authors: H
authors: Un
authors: Joseph R
authors: JR
authors: Volpicelli
authors: Charles
authors: C
authors: Ruetsch
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016022:Case-Control Studies; D059350:Chronic Pain / Q000188:drug therapy* / Q000191:economics*; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000191:economics* / Q000517:prevention & control; D012189:Retrospective Studies; D014481:United States
chemical_list: D000701:Analgesics, Opioid