The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013

Med Care. 2016 Oct;54(10):901-6. doi: 10.1097/MLR.0000000000000625.

Abstract

Importance: It is important to understand the magnitude and distribution of the economic burden of prescription opioid overdose, abuse, and dependence to inform clinical practice, research, and other decision makers. Decision makers choosing approaches to address this epidemic need cost information to evaluate the cost effectiveness of their choices.

Objective: To estimate the economic burden of prescription opioid overdose, abuse, and dependence from a societal perspective.

Design, setting, and participants: Incidence of fatal prescription opioid overdose from the National Vital Statistics System, prevalence of abuse and dependence from the National Survey of Drug Use and Health. Fatal data are for the US population, nonfatal data are a nationally representative sample of the US civilian noninstitutionalized population ages 12 and older. Cost data are from various sources including health care claims data from the Truven Health MarketScan Research Databases, and cost of fatal cases from the WISQARS (Web-based Injury Statistics Query and Reporting System) cost module. Criminal justice costs were derived from the Justice Expenditure and Employment Extracts published by the Department of Justice. Estimates of lost productivity were based on a previously published study.

Exposure: Calendar year 2013.

Main outcomes and measures: Monetized burden of fatal overdose and abuse and dependence of prescription opioids.

Results: The total economic burden is estimated to be $78.5 billion. Over one third of this amount is due to increased health care and substance abuse treatment costs ($28.9 billion). Approximately one quarter of the cost is borne by the public sector in health care, substance abuse treatment, and criminal justice costs.

Conclusions and relevance: These estimates can assist decision makers in understanding the magnitude of adverse health outcomes associated with prescription opioid use such as overdose, abuse, and dependence.

MeSH terms

  • Absenteeism
  • Cost of Illness*
  • Criminal Law / economics
  • Criminal Law / statistics & numerical data
  • Female
  • Health Care Costs / statistics & numerical data
  • Humans
  • Male
  • Opioid-Related Disorders / economics*
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / mortality
  • Prescription Drug Misuse / economics*
  • Prescription Drug Misuse / mortality
  • Prescription Drug Misuse / statistics & numerical data
  • Prescription Drug Overuse / economics*
  • Prescription Drug Overuse / statistics & numerical data
  • United States / epidemiology