THE IMPACT OF HIGH RISK AND CHRONIC OPOID USE AMONG COMMERCIALLY INSURED ENDOMETRIOSIS PATIENTS ON HEALTHCARE RESOURCE USE AND COSTS IN THE UNITED STATES

Evaluate incremental all-cause healthcare resource use (HCRU) and costs among newly diagnosed endometriosis patients with high-risk or chronic opioid use. Retrospective analysis of © 2019 Truven Health Analytics LLC All Rights Reserved claims database was performed for females aged 18-49 with ≥1 endometriosis diagnosis within 2009-2018. Index date was the first opioid prescription date within 12 months following the earliest endometriosis diagnosis. High-risk utilization was defined as ≥90 morphine milligram equivalents per day or ≥1-day of concomitant opioid and benzodiazepine use whereas chronic utilization was defined as ≥90-day opioids supply or ≥10 opioid prescriptions during 12-month post-index (exposure period). HCRU and costs were assessed over the 12-months following the exposure period (post-exposure period) and compared between endometriosis patients who met high-risk or chronic opioid definition and those who did not using negative binomial regression and gamma regression models as appropriate adjusted for demographic and baseline clinical characteristics. Among 61,019 patients in the analysis (mean [SD] age 38.3 [7.3] years), 11.6% had high-risk opioid-use and 8.3% chronic opioid-use. During the post-exposure period, high-risk opioid users had significantly more outpatient (18.6 vs. 14.9), inpatient (0.2 vs. 0.1), and emergency room visits (0.8 vs. 0.5), higher prescription utilization (21.3 vs. 16.9 fills), longer inpatient stay (1.1. vs. 0.6 days), and higher total costs ($17,993 vs. $12,213); (all p<0.0001) compared to low-risk opioid-users. Similarly, mean number of visits was significantly higher among chronic opioid-users vs. non-chronic users (19.2 vs. 14.7 outpatient, 0.3 vs. 0.1 inpatient, and 0.9 vs. 0.5 emergency room visits), number of prescriptions was greater (23.3 vs. 16.5 fills), length of stay was longer (1.2 vs. 0.6 days), and total costs were higher ($20,240 vs. $11,770); (all p<0.0001). High-risk and chronic opioid use among endometriosis patients is associated with a significant HCRU and total health care costs burden.