title: Systemic opioid elimination after implantation of an intrathecal drug delivery system significantly reduced health-care expenditures.
abstract: OBJECTIVE
  To compare health-care expenditures over a 12-month horizon for chronic pain patients with implanted intrathecal drug delivery systems (IDDS) who eliminated or continued systemic opioids postimplant.
  
  
  METHODS
  Claims data from commercial and Medicare databases were searched for patients who had an IDDS, used systemic opioids before implant, and had 12 months pre- and 13 months postimplant continuous medical and pharmacy coverage. The number and characteristics of patients who eliminated or continued systemic opioids were determined at four times postimplant: 30 days (allowing a systemic opioid washout period), 120 days, 150 days, and 210 days. Multivariable models evaluated the effect of eliminating opioids on health-care expenditures at each of those times.
  
  
  RESULTS
  Three hundred eighty-nine patients met inclusion criteria, and 51% completely eliminated systemic opioids (12% within the 30-day washout and an additional 39% by the end of the one-year horizon). Systemic opioid elimination within 120 to 210 days postimplant was associated with a reduction of $3,388 to $4,465 in inpatient and outpatient expenditures, and $4,689 to $5,571 in inpatient, outpatient, and drug expenditures.
  
  
  CONCLUSIONS
  Fifty-one percent of patients completely eliminated systemic opioids in the year after IDDS implant. This elimination resulted in a 10% to 17% reduction in yearly inpatient, outpatient, and drug expenditures.
authors: Northwest Pain Care, Inc., Spokane, WA, USA.
authors: John A
authors: JA
authors: Hatheway
authors: David
authors: D
authors: Caraway
authors: Guy
authors: G
authors: David
authors: Candace
authors: C
authors: Gunnarsson
authors: Jennifer
authors: J
authors: Hinnenthal
authors: Amanda R
authors: AR
authors: Ernst
authors: Michael
authors: M
authors: Saulino
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data; D003695:Delivery of Health Care; D016503:Drug Delivery Systems; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid
keywords: Chronic pain; database review; health-care expenditure; intrathecal drug delivery; opioid