Trends of per-patient healthcare cost and resource utilization of opioid use disorder among privately insured individuals in the United States from 2005-2014

Background Little are known about how per-patient healthcare cost and resource utilization of Opioid Use Disorder (OUD) have changed over time when governments continue to reduce availability and utilization barrier of OUD treatment. Objectives Investigate trends of per-patient healthcare cost and utilization of outpatient, inpatient and emergency department services among privately insured individuals with OUD from 2005 to 2014. Methods The MarketScan® Commercial Claims and Encounters database was used to analyze healthcare cost and resource utilization of opioid used disorder from 2005 to 2014. A matched case-control design was employed to estimate the impact of OUD on healthcare cost and service utilization over this period. Main findings Excess annual per-patient healthcare cost of OUD stayed relatively stable with an average of $14,586 between 2005 and 2014. However, excess outpatient cost increased while excess inpatient cost decreased over time. Among OUD patients, the increase of OUD related outpatient care utilization rate and average number of visits coincided with the decrease of inpatient and ED service utilization rates and average number of ED visits. Conclusions Among OUD patients, the increasing per-patient utilization of OUD related outpatient care, together with the decline in per-patient utilization of more urgent care including inpatient and emergency department care might indicate increased awareness and diagnosis of OUD and a better control of the disease among existing patients with private insurance. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No external funding was received for this research. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The proposed study used only secondary data from private insurance medical claims database (Marketscan). The database has been stripped of identifiers. The research material obtained from human subjects is in the form of data acquired from IBM Truven Health Analytics, specially designed for research use. The subjects from the database that made available to us can be neither identifiable nor linkable by us. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data used in the study come from the MarketScan Commercial Claims and Encounters database. Although we are not allowed to share the data, the data are publicly available with purchase.