Report: Opioid addiction costs big companies $2.6B

April 5 (UPI) — Large employers spent $2.6 billion to treat opioid addiction and overdoses in 2016, according to a report released Thursday by the nonpartisan Kaiser Family Foundation.

Addiction cost large companies nearly 10 times more than it did in 2004, when those businesses paid $273 million, Kaiser said in a report.

But the percentage of enrollees taking opioid prescriptions is down nearly 3 percentage points from a peak of 17.3 percent in 2009 to 13.6 percent in 2016. In 2004, it was 15.7 percent.

The foundation determined that the addiction costs for each enrollee was $26, paid by companies and workers.

The average inpatient expense for opioid addiction treatment was $16,104 in 2016, up from $5,809 in 2004, the report said. About 53 percent of the spending was for enrollees’ dependent children.

Opioid prescription use is highest among older enrollees — 22 percent of people 55-64 had at least one opioid prescription in 2016.

Also, it’s higher among people in the South at 16 percent — compared with 14 percent in the Midwest, 12 percent in the West and 11 percent in the Northeast.

The report noted some of the biggest declines in opioid prescription use since 2009 were among people with complications from pregnancy or childbirth, musculoskeletal conditions and injuries.

The percentage of people experiencing complications from pregnancy or childbirth who received an opioid prescription peaked in 2007 with 35 percent and dropped to 26 percent in 2016. Among people with a musculoskeletal condition, opioid prescription use was 37 percent in 2007 and dropped to 30 percent by 2016. Among people with injuries, it went from 37 percent in 2009 to 30 percent in 2016.

The report found that opioid addiction and overdose treatment prescriptions cost an average of $436 in 2016, with $376 paid by insurers and $60 paid out of pocket. In 2004, the cost was around $20, mostly paid by insurers.

The total addiction and overdose prescription spending was $400 million in 2016, compared with $25 million in 2004.

Private insurance covers 37 percent of the non-elderly adults with opioid addiction compared with 38 percent with Medicaid, 17 percent uninsured and 8 percent others/unknown.

Kaiser based the analysis on a sample of health benefit claims of companies with more than 1,000 workers from the Truven MarketScan Commercial Claims and Encounters Database. Then the amounts paid by insurance and out-of-pocket on prescription drugs from 2004 to 2016 was calculated.

Because most companies are self-insured, they assume all of the financial risk.

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