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Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015

Emma Davies, Ceri Phillips, Mari Jones, Berni Sewell Orcid Logo

British Journal of Pain, Volume: 16, Issue: 2, Start page: 204946372110458

Swansea University Authors: Ceri Phillips, Berni Sewell Orcid Logo

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DOI (Published version): 10.1177/20494637211045898

Abstract

ObjectiveTo examine differences in healthcare utilisation and costs associated with opioid prescriptions for non-cancer pain issued in primary care.MethodA longitudinal, case-control study retrospectively examined Welsh healthcare data for the period 1 January 2005–31 December 2015. Data were extrac...

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Published in: British Journal of Pain
ISSN: 2049-4637 2049-4645
Published: SAGE Publications 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa59130
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Data were extracted from the Secure Anonymised Information Linkage (SAIL) databank. Subjects, aged 18 years and over, were included if their primary care record contained at least one of six overarching pain diagnoses during the study period. Subjects were excluded if their record also contained a cancer diagnosis in that time or the year prior to the study period. Case subjects also received at least one prescription for an opioid analgesic. Controls were matched by gender, age, pain-diagnosis and socioeconomic deprivation. Healthcare use included primary care visits, emergency department (ED) and outpatient (OPD) attendances, inpatient (IP) admissions and length of stay. Cost analysis for healthcare utilisation used nationally derived unit costs for 2015. Differences between case and control subjects for resource use and costs were analysed and further stratified by gender, prescribing persistence (PP) and deprivation.ResultsData from 3,286,215 individuals were examined with 657,243 receiving opioids. Case subjects averaged 5 times more primary care visits, 2.8 times more OPD attendances, 3 times more ED visits and twice as many IN admissions as controls. Prescription persistence over 6 months and greater deprivation were associated with significantly greater utilisation of healthcare resources. Opioid prescribing was associated with 69% greater average healthcare costs than in control subjects. National Health Service (NHS) healthcare service costs for people with common, pain-associated diagnoses, receiving opioid analgesics were estimated to be &#xA3;0.9billion per year between 2005 and 2015.ConclusionReceipt of opioid prescriptions was associated with significantly greater healthcare utilisation and accompanying costs in all sectors. Extended prescribing durations are particularly important to address and should be considered at the point of initiation.</abstract><type>Journal Article</type><journal>British Journal of Pain</journal><volume>16</volume><journalNumber>2</journalNumber><paginationStart>204946372110458</paginationStart><paginationEnd/><publisher>SAGE Publications</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2049-4637</issnPrint><issnElectronic>2049-4645</issnElectronic><keywords>Opioid analgesics, non-cancer pain, resource utilisation, healthcare costs, cost analysis</keywords><publishedDay>3</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-11-03</publishedDate><doi>10.1177/20494637211045898</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>Pharmacy Research UK grant number PRUK-2016-PA1-A. 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spelling 2022-04-19T15:35:14.8409193 v2 59130 2022-01-10 Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015 932c7a406ab4b6e4a881d422ca03c289 Ceri Phillips Ceri Phillips true false f6a4af2cfa4275d2a8ebba292fa14421 0000-0001-5471-922X Berni Sewell Berni Sewell true false 2022-01-10 FGMHL ObjectiveTo examine differences in healthcare utilisation and costs associated with opioid prescriptions for non-cancer pain issued in primary care.MethodA longitudinal, case-control study retrospectively examined Welsh healthcare data for the period 1 January 2005–31 December 2015. Data were extracted from the Secure Anonymised Information Linkage (SAIL) databank. Subjects, aged 18 years and over, were included if their primary care record contained at least one of six overarching pain diagnoses during the study period. Subjects were excluded if their record also contained a cancer diagnosis in that time or the year prior to the study period. Case subjects also received at least one prescription for an opioid analgesic. Controls were matched by gender, age, pain-diagnosis and socioeconomic deprivation. Healthcare use included primary care visits, emergency department (ED) and outpatient (OPD) attendances, inpatient (IP) admissions and length of stay. Cost analysis for healthcare utilisation used nationally derived unit costs for 2015. Differences between case and control subjects for resource use and costs were analysed and further stratified by gender, prescribing persistence (PP) and deprivation.ResultsData from 3,286,215 individuals were examined with 657,243 receiving opioids. Case subjects averaged 5 times more primary care visits, 2.8 times more OPD attendances, 3 times more ED visits and twice as many IN admissions as controls. Prescription persistence over 6 months and greater deprivation were associated with significantly greater utilisation of healthcare resources. Opioid prescribing was associated with 69% greater average healthcare costs than in control subjects. National Health Service (NHS) healthcare service costs for people with common, pain-associated diagnoses, receiving opioid analgesics were estimated to be £0.9billion per year between 2005 and 2015.ConclusionReceipt of opioid prescriptions was associated with significantly greater healthcare utilisation and accompanying costs in all sectors. Extended prescribing durations are particularly important to address and should be considered at the point of initiation. Journal Article British Journal of Pain 16 2 204946372110458 SAGE Publications 2049-4637 2049-4645 Opioid analgesics, non-cancer pain, resource utilisation, healthcare costs, cost analysis 3 11 2021 2021-11-03 10.1177/20494637211045898 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University Pharmacy Research UK grant number PRUK-2016-PA1-A. ED’s PhD is partly supported by funding from Research Capacity Building Collaboration (RCBC Wales). 2022-04-19T15:35:14.8409193 2022-01-10T15:11:03.6918512 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Emma Davies 1 Ceri Phillips 2 Mari Jones 3 Berni Sewell 0000-0001-5471-922X 4 59130__22179__9bfff26dc9bd4ee59b4ed18adb223c27.pdf 59130.pdf 2022-01-18T16:35:18.5463080 Output 987042 application/pdf Version of Record true This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License true eng https://creativecommons.org/licenses/by-nc/4.0/
title Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015
spellingShingle Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015
Ceri Phillips
Berni Sewell
title_short Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015
title_full Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015
title_fullStr Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015
title_full_unstemmed Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015
title_sort Healthcare resource utilisation and cost analysis associated with opioid analgesic use for non-cancer pain: A case-control, retrospective study between 2005 and 2015
author_id_str_mv 932c7a406ab4b6e4a881d422ca03c289
f6a4af2cfa4275d2a8ebba292fa14421
author_id_fullname_str_mv 932c7a406ab4b6e4a881d422ca03c289_***_Ceri Phillips
f6a4af2cfa4275d2a8ebba292fa14421_***_Berni Sewell
author Ceri Phillips
Berni Sewell
author2 Emma Davies
Ceri Phillips
Mari Jones
Berni Sewell
format Journal article
container_title British Journal of Pain
container_volume 16
container_issue 2
container_start_page 204946372110458
publishDate 2021
institution Swansea University
issn 2049-4637
2049-4645
doi_str_mv 10.1177/20494637211045898
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
document_store_str 1
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description ObjectiveTo examine differences in healthcare utilisation and costs associated with opioid prescriptions for non-cancer pain issued in primary care.MethodA longitudinal, case-control study retrospectively examined Welsh healthcare data for the period 1 January 2005–31 December 2015. Data were extracted from the Secure Anonymised Information Linkage (SAIL) databank. Subjects, aged 18 years and over, were included if their primary care record contained at least one of six overarching pain diagnoses during the study period. Subjects were excluded if their record also contained a cancer diagnosis in that time or the year prior to the study period. Case subjects also received at least one prescription for an opioid analgesic. Controls were matched by gender, age, pain-diagnosis and socioeconomic deprivation. Healthcare use included primary care visits, emergency department (ED) and outpatient (OPD) attendances, inpatient (IP) admissions and length of stay. Cost analysis for healthcare utilisation used nationally derived unit costs for 2015. Differences between case and control subjects for resource use and costs were analysed and further stratified by gender, prescribing persistence (PP) and deprivation.ResultsData from 3,286,215 individuals were examined with 657,243 receiving opioids. Case subjects averaged 5 times more primary care visits, 2.8 times more OPD attendances, 3 times more ED visits and twice as many IN admissions as controls. Prescription persistence over 6 months and greater deprivation were associated with significantly greater utilisation of healthcare resources. Opioid prescribing was associated with 69% greater average healthcare costs than in control subjects. National Health Service (NHS) healthcare service costs for people with common, pain-associated diagnoses, receiving opioid analgesics were estimated to be £0.9billion per year between 2005 and 2015.ConclusionReceipt of opioid prescriptions was associated with significantly greater healthcare utilisation and accompanying costs in all sectors. Extended prescribing durations are particularly important to address and should be considered at the point of initiation.
published_date 2021-11-03T04:16:12Z
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score 11.016861

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