Estimating the costs of opioid abuse and dependence from an employer perspective: a retrospective analysis using administrative claims data

Appl Health Econ Health Policy. 2014 Aug;12(4):435-46. doi: 10.1007/s40258-014-0102-0.


Background: Opioid abuse and dependence is problematic across many age groups, including the working-age population and their dependents. Little is known, however, about the economic costs of opioid abuse/dependence imposed on employers, who pay for a substantial portion of healthcare costs through their contributions to employer-sponsored health insurance and are also affected by indirect costs such as those due to disability and workplace absenteeism.

Objective: To provide a comprehensive, current estimate of the economic burden of prescription opioid abuse/dependence to employers.

Methods: Administrative claims from beneficiaries covered by large self-insured companies throughout the USA were used to identify patients, including employees and dependents, who were diagnosed with opioid abuse and/or dependence ('abusers') between 2006 and 2012. Healthcare and work-loss costs for abusers were assessed over a 12-month period and compared with those for patients not diagnosed with abuse ('comparison patients'), using propensity score matching.

Results: 7,658 matched pairs of abusers and comparison patients were analysed. Relative to comparison patients, abusers had significantly higher annual healthcare resource utilization, leading to US$10,627 in per-patient incremental annual healthcare costs. Additionally, abusers had US$1,244 in excess annual work-loss costs. Together, this implies an employer burden for diagnosed abuse of US$1.71 per member per month.

Conclusion: Opioid abuse/dependence impose a substantial economic burden on employers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Costs and Cost Analysis
  • Drug Users*
  • Employment / economics*
  • Female
  • Humans
  • Insurance Claim Review
  • Male
  • Middle Aged
  • Occupational Health / economics*
  • Opioid-Related Disorders / economics*
  • Opioid-Related Disorders / epidemiology
  • Prevalence
  • Propensity Score
  • Retrospective Studies
  • Sick Leave / economics
  • United States / epidemiology
  • Young Adult