Non-adherence to chronic opioid therapy increases healthcare costs and hospital days

Patients undergoing opioid therapy for chronic pain who may not be following their prescription regimen have significantly higher overall healthcare costs, Ameritox Ltd. announced recently. The study was published in The American Journal of Managed Care.

"Considering all of the discussion right now around healthcare reform and controlling healthcare spending, this study highlights an opportunity to better manage a costly and at-risk population of patients – those on chronic opioid therapy," said Harry L. Leider, MD, co-author of the study.  Dr. Leider is Chief Medical Officer at Ameritox – a corporate sponsor of the research –and a faculty member with the American College of Physician Executives. "By focusing on patients who receive opioids and are likely non-adherent, clinicians can take concrete steps to improve patient safety and, ultimately, lower costs."  

The study analyzed managed care claims of more than 18 million patients, identifying a subset of pain patients on chronic opioid therapy. The study determined that patients on chronic opioid therapy who were likely non-adherent, as determined by urine drug testing results, had 14 percent higher healthcare costs and 35 percent more hospital days.

Likely non-adherence to prescribed opioid therapy was identified through urine drug monitoring results and included patients with results of a prescribed medication not found, the presence of a non-prescribed drug, the presence of an illicit drug found in the urine, or based on the expected amount of a prescribed drug found.

The study concluded that improving adherence among patients with chronic pain could help reduce healthcare spending and improve health outcomes. "Opioids are an important tool in pain management," added Leider. "This study reinforces a growing belief that pain medication monitoring must be part of the pain management paradigm.  Urine drug monitoring can provide clinicians with information to help improve medication adherence and outcomes among their patients, while controlling overall costs."

Among the Key Findings in the Study:

• Overall healthcare spending for patients on chronic opioid therapy was over $23,000 per year (2008 dollars)
• Total healthcare costs were 14 percent higher for likely non-adherent patients ($26,433) over a 12 month period following initial urine drug testing.
• Likely non-adherent patients had 35 percent more hospital days.