TY - JOUR
T1 - Costs of care for persons with opioid dependence in commercial integrated health systems
AU - Lynch, Frances L.
AU - McCarty, Dennis
AU - Mertens, Jennifer
AU - Perrin, Nancy A.
AU - Green, Carla A.
AU - Parthasarathy, Sujaya
AU - Dickerson, John F.
AU - Anderson, Bradley M.
AU - Pating, David
N1 - Funding Information:
We gratefully acknowledge funding from the National Institute on Drug Abuse, (R01 DA016341). The authors thank Elizabeth Shuster for her hard work on the statistical analyses, and Jonathan Fine for editorial help.
Publisher Copyright:
© 2014 Lynch et al.; licensee BioMed Central Ltd.
PY - 2014/1/27
Y1 - 2014/1/27
N2 - Background: When used in general medical practices, buprenorphine is an effective treatment for opioid dependence, yet little is known about how use of buprenorphine affects the utilization and cost of health care in commercial health systems. Methods: The objective of this retrospective cohort study was to examine how buprenorphine affects patterns of medical care, addiction medicine services, and costs from the health system perspective. Individuals with two or more opioid-dependence diagnoses per year, in two large health systems (System A: n = 1836; System B: n = 4204) over the time span 2007-2008 were included. Propensity scores were used to help adjust for group differences. Results: Patients receiving buprenorphine plus addiction counseling had significantly lower total health care costs than patients with little or no addiction treatment (mean health care costs with buprenorphine treatment = $13,578; vs. mean health care costs with no addiction treatment = $31,055; p <.0001), while those receiving buprenorphine plus addiction counseling and those with addiction counseling only did not differ significantly in total health care costs (mean costs with counseling only: $17,017; p =.5897). In comparison to patients receiving buprenorphine plus counseling, those with little or no addiction treatment had significantly greater use of primary care (p <.001), other medical visits (p =.001), and emergency services (p =.020). Patients with counseling only (compared to patients with buprenorphine plus counseling) used less inpatient detoxification (p <.001), and had significantly more PC visits (p =.001), other medical visits (p =.005), and mental health visits (p =.002). Conclusions: Buprenorphine is a viable alternative to other treatment approaches for opioid dependence in commercial integrated health systems, with total costs of health care similar to abstinence-based counseling. Patients with buprenorphine plus counseling had reduced use of general medical services compared to the alternatives.
AB - Background: When used in general medical practices, buprenorphine is an effective treatment for opioid dependence, yet little is known about how use of buprenorphine affects the utilization and cost of health care in commercial health systems. Methods: The objective of this retrospective cohort study was to examine how buprenorphine affects patterns of medical care, addiction medicine services, and costs from the health system perspective. Individuals with two or more opioid-dependence diagnoses per year, in two large health systems (System A: n = 1836; System B: n = 4204) over the time span 2007-2008 were included. Propensity scores were used to help adjust for group differences. Results: Patients receiving buprenorphine plus addiction counseling had significantly lower total health care costs than patients with little or no addiction treatment (mean health care costs with buprenorphine treatment = $13,578; vs. mean health care costs with no addiction treatment = $31,055; p <.0001), while those receiving buprenorphine plus addiction counseling and those with addiction counseling only did not differ significantly in total health care costs (mean costs with counseling only: $17,017; p =.5897). In comparison to patients receiving buprenorphine plus counseling, those with little or no addiction treatment had significantly greater use of primary care (p <.001), other medical visits (p =.001), and emergency services (p =.020). Patients with counseling only (compared to patients with buprenorphine plus counseling) used less inpatient detoxification (p <.001), and had significantly more PC visits (p =.001), other medical visits (p =.005), and mental health visits (p =.002). Conclusions: Buprenorphine is a viable alternative to other treatment approaches for opioid dependence in commercial integrated health systems, with total costs of health care similar to abstinence-based counseling. Patients with buprenorphine plus counseling had reduced use of general medical services compared to the alternatives.
KW - Commercial health insurance
KW - Cost analysis
KW - Health care utilization
KW - Parity
KW - Substance abuse
UR - http://www.scopus.com/inward/record.url?scp=84907722062&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84907722062&partnerID=8YFLogxK
U2 - 10.1186/1940-0640-9-16
DO - 10.1186/1940-0640-9-16
M3 - Article
C2 - 25123823
AN - SCOPUS:84907722062
SN - 1940-0632
VL - 9
JO - Addiction Science and Clinical Practice
JF - Addiction Science and Clinical Practice
IS - 1
M1 - 16
ER -