학술논문

Health care resource use and cost differences by opioid therapy type among chronic noncancer pain patients
Document Type
article
Source
Journal of Pain Research, Vol Volume 10, Pp 1713-1722 (2017)
Subject
chronic pain
opioids
costs
utilization
long-acting opioid
Medicine (General)
R5-920
Language
English
ISSN
1178-7090
Abstract
Pamela B Landsman-Blumberg,1 Nathaniel Katz,2,3 Kavita Gajria,4 Anna O D’Souza,1 Sham L Chaudhari,1 Paul P Yeung,5 Richard White6 1Real-World Evidence, Xcenda LLC, Palm Harbor, FL, 2Analgesic Solutions, Natick, MA, 3Tufts University School of Medicine, Boston, MA, 4Global Health Economics Outcomes Research, Teva Pharmaceuticals, Inc., Frazer, PA, 5Migraine and Headache Clinical Development, Teva Pharmaceuticals, Inc., Frazer, PA, 6Neuroscience, Angarrack Value Solutions, West Chester, PA, USA Abstract: The study assessed 12-month chronic pain (CP)-related health care utilization and costs among chronic noncancer pain (CNCP) patients who initiated various long-term opioid treatments. Treatments included monotherapy with long-acting opioids (mono-LAOs), monotherapy with short-acting opioids (mono-SAOs), both LAOs and SAOs (combination), and opioid therapy initiated with SAO or LAO and switched to the other class (switch). Using MarketScan® claims databases (2006–2012), we identified CNCP patients with ≥90 days opioid supply after pain diagnosis and continuous enrollment 12 months before pain diagnosis (baseline period) and 12 months after opioid start (post-index period). Outcomes included CP-related health care utilization and costs. Among CNCP patients (n=21,203), the cohort distribution was 74% mono-SAOs, 22% combination, 2% mono-LAOs, and 2% switch. During follow-up, the average daily morphine equivalent dose was highest in mono-LAO patients (96.4 mg) compared with combination patients (89.8 mg), switch patients (64.3 mg), and mono-SAO patients (36.2 mg). After adjusting for baseline differences, the mono-LAO cohort had lower total CP-related costs ($4,933) compared with the mono-SAO ($8,604), switch ($10,470), and combination ($15,190) cohorts (all: P