TY - JOUR
T1 - A real-world study using claims data to evaluate possible failure of opioid treatment regimens among patients with hip and/or knee osteoarthritis in the US
AU - Gandhi, Kavita
AU - Wei, Wenhui
AU - Huang, Ahong
AU - Wang, Li
AU - Iyer, Ravi
AU - Katz, Nathaniel P.
N1 - Funding Information:
This research was funded by Regeneron Pharmaceuticals Inc. and Teva Pharmaceutical Industries Ltd. The authors acknowledge E. Jay Bienen, PhD, for medical writing support during development of this manuscript, and Michele Salernitano of Ashfield Healthcare Communications for editorial support.
Publisher Copyright:
© 2020 Gandhi et al.
PY - 2020
Y1 - 2020
N2 - Background: Although opioids may be used in the management of pain in patients with osteoarthritis (OA), there is a dearth of real-world data characterizing opioid regimen failure in these patients. Objective: Using claims data, this study explored measures that may be potentially indica-tive of opioid treatment failure and the association of such potential failure with health care resource utilization (HRU) and costs. Patients and Methods: Using a national employer-sponsored insurance claims database covering the years 2011–2016, this retrospective longitudinal study identified adults with hip/ knee osteoarthritis who filled ≥1 opioid prescription (index event) and had continuous health plan enrollment 6 months pre-and ≥12 months post-index. Index opioid regimen intensity was defined in the 3-month post-index period by frequency, average daily dose, and duration of action. Possible index opioid regimen failure was defined as an increase in opioid regimen intensity, addition of a non-opioid pain medication, joint surgery, or opioid-abuse-related events. One-year follow-up HRU and costs were compared between those with possible treatment failure and those without. Results: Among 271,512 OA patients (61.5% knee; 11.1% hip; 27.4% both), 34.9% met the definition of possible index opioid regimen failure within a year: increased regimen intensity (16.1%), joint surgery (14.0%), addition of non-opioid pain medication (11.4%), and opioid-abuse-related events (1.9%). Rates of possible failure generally increased with higher index regimen intensity. Compared with those who did not fail, those who potentially failed their index treatment regimen had significantly higher HRU (P<0.001), and all-cause ($36,699 vs $15,114) and osteoarthritis-related costs ($17,298 vs $1,967) (both P<0.0001). Conclusion: Among OA patients treated with opioids, approximately one-third may fail their index opioid regimen within a year and incur significantly higher HRU and costs than those without. Further research is needed to validate these findings with clinical outcomes.
AB - Background: Although opioids may be used in the management of pain in patients with osteoarthritis (OA), there is a dearth of real-world data characterizing opioid regimen failure in these patients. Objective: Using claims data, this study explored measures that may be potentially indica-tive of opioid treatment failure and the association of such potential failure with health care resource utilization (HRU) and costs. Patients and Methods: Using a national employer-sponsored insurance claims database covering the years 2011–2016, this retrospective longitudinal study identified adults with hip/ knee osteoarthritis who filled ≥1 opioid prescription (index event) and had continuous health plan enrollment 6 months pre-and ≥12 months post-index. Index opioid regimen intensity was defined in the 3-month post-index period by frequency, average daily dose, and duration of action. Possible index opioid regimen failure was defined as an increase in opioid regimen intensity, addition of a non-opioid pain medication, joint surgery, or opioid-abuse-related events. One-year follow-up HRU and costs were compared between those with possible treatment failure and those without. Results: Among 271,512 OA patients (61.5% knee; 11.1% hip; 27.4% both), 34.9% met the definition of possible index opioid regimen failure within a year: increased regimen intensity (16.1%), joint surgery (14.0%), addition of non-opioid pain medication (11.4%), and opioid-abuse-related events (1.9%). Rates of possible failure generally increased with higher index regimen intensity. Compared with those who did not fail, those who potentially failed their index treatment regimen had significantly higher HRU (P<0.001), and all-cause ($36,699 vs $15,114) and osteoarthritis-related costs ($17,298 vs $1,967) (both P<0.0001). Conclusion: Among OA patients treated with opioids, approximately one-third may fail their index opioid regimen within a year and incur significantly higher HRU and costs than those without. Further research is needed to validate these findings with clinical outcomes.
KW - Costs
KW - Health care resource use
KW - Opioids
KW - Osteoarthritis
KW - Pain
KW - Treatment failure
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U2 - 10.2147/CEOR.S244329
DO - 10.2147/CEOR.S244329
M3 - Article
C2 - 32606845
AN - SCOPUS:85088801056
SN - 1178-6981
VL - 12
SP - 285
EP - 297
JO - ClinicoEconomics and Outcomes Research
JF - ClinicoEconomics and Outcomes Research
ER -