Jody L Green, Taryn Dailey-Govoni, Suzanne K Vosburg
{"title":"滥用/误用羟考酮制剂后与阿片类药物相关的临床结果和相关医疗费用:对真实世界数据的 HEOR 分析。","authors":"Jody L Green, Taryn Dailey-Govoni, Suzanne K Vosburg","doi":"10.5055/jom.0878","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The United States (US) opioid epidemic is a continued burden on the healthcare system and on the lives of individuals affected by the consequences of opioid abuse/misuse. The objective of this study was to use real-world data from intentional abuse/misuse exposures managed by US poison centers to compare clinical outcomes and quantify healthcare costs among three study cohorts: -exposures that involved Xtampza ER®, other oxycodone extended-release (ER), and oxycodone immediate-release (IR).</p><p><strong>Study design: </strong>A real-world, observational study.</p><p><strong>Main outcome measures: </strong>Descriptive statistics were used to describe patient and exposure characteristics. Drug utilization-adjusted rates of intentional abuse/misuse and clinical outcomes were used to determine relative risk. Healthcare cost estimates were calculated by extrapolating average charge per opioid-related disorder emergency department (ED) visit and per inpatient stay based upon case disposition rates, adjusted for population and drug utilization.</p><p><strong>Results: </strong>Compared to Xtampza ER, exposures that involved other oxycodone ER were 7.4 times more likely to be intentional abuse/misuse, 25.9 times more likely to result in major effect or death, 9.7 times more likely to require a visit to the ED, and 14.3 times more likely to result in hospital admission. Similar results were found for oxycodone IR when compared to Xtampza ER.</p><p><strong>Conclusions: </strong>This study is the first of its kind to synthesize clinical outcomes with opioid-related healthcare costs, suggesting that even when Xtampza ER is abused/misused, the rates of major effect/death, ED visits, and hospital admissions were significantly lower than those for other oxycodone-containing medications, resulting in relatively low downstream opioid-related healthcare costs.</p>","PeriodicalId":16601,"journal":{"name":"Journal of opioid management","volume":"20 4","pages":"281-288"},"PeriodicalIF":0.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Opioid-related clinical outcomes and associated healthcare costs following abuse/misuse of oxycodone formulations: A HEOR analysis from real-world data.\",\"authors\":\"Jody L Green, Taryn Dailey-Govoni, Suzanne K Vosburg\",\"doi\":\"10.5055/jom.0878\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The United States (US) opioid epidemic is a continued burden on the healthcare system and on the lives of individuals affected by the consequences of opioid abuse/misuse. The objective of this study was to use real-world data from intentional abuse/misuse exposures managed by US poison centers to compare clinical outcomes and quantify healthcare costs among three study cohorts: -exposures that involved Xtampza ER®, other oxycodone extended-release (ER), and oxycodone immediate-release (IR).</p><p><strong>Study design: </strong>A real-world, observational study.</p><p><strong>Main outcome measures: </strong>Descriptive statistics were used to describe patient and exposure characteristics. Drug utilization-adjusted rates of intentional abuse/misuse and clinical outcomes were used to determine relative risk. Healthcare cost estimates were calculated by extrapolating average charge per opioid-related disorder emergency department (ED) visit and per inpatient stay based upon case disposition rates, adjusted for population and drug utilization.</p><p><strong>Results: </strong>Compared to Xtampza ER, exposures that involved other oxycodone ER were 7.4 times more likely to be intentional abuse/misuse, 25.9 times more likely to result in major effect or death, 9.7 times more likely to require a visit to the ED, and 14.3 times more likely to result in hospital admission. Similar results were found for oxycodone IR when compared to Xtampza ER.</p><p><strong>Conclusions: </strong>This study is the first of its kind to synthesize clinical outcomes with opioid-related healthcare costs, suggesting that even when Xtampza ER is abused/misused, the rates of major effect/death, ED visits, and hospital admissions were significantly lower than those for other oxycodone-containing medications, resulting in relatively low downstream opioid-related healthcare costs.</p>\",\"PeriodicalId\":16601,\"journal\":{\"name\":\"Journal of opioid management\",\"volume\":\"20 4\",\"pages\":\"281-288\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of opioid management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5055/jom.0878\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of opioid management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5055/jom.0878","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:美国阿片类药物的流行对医疗保健系统和受阿片类药物滥用/误用后果影响的个人生活造成了持续的负担。本研究的目的是利用美国毒物中心管理的故意滥用/误用暴露的真实数据,比较三个研究队列的临床结果并量化医疗成本:-研究设计:主要结果测量:采用描述性统计来描述患者和暴露特征。采用药物使用调整后的故意滥用/误用率和临床结果来确定相对风险。根据病例处置率推算每次阿片类药物相关疾病急诊就诊和每次住院的平均费用,并根据人口和药物使用情况进行调整,从而计算出医疗成本估算值:与 Xtampza ER 相比,涉及其他羟考酮 ER 的故意滥用/误用可能性高出 7.4 倍,导致重大影响或死亡的可能性高出 25.9 倍,需要到急诊科就诊的可能性高出 9.7 倍,导致住院的可能性高出 14.3 倍。与Xtampza ER相比,羟考酮IR也发现了类似的结果:这项研究首次将临床结果与阿片类药物相关的医疗成本综合在一起,表明即使 Xtampza ER 被滥用/误用,其主要影响/死亡、急诊室就诊率和入院率也明显低于其他含羟考酮的药物,因此阿片类药物相关的下游医疗成本相对较低。
Opioid-related clinical outcomes and associated healthcare costs following abuse/misuse of oxycodone formulations: A HEOR analysis from real-world data.
Objective: The United States (US) opioid epidemic is a continued burden on the healthcare system and on the lives of individuals affected by the consequences of opioid abuse/misuse. The objective of this study was to use real-world data from intentional abuse/misuse exposures managed by US poison centers to compare clinical outcomes and quantify healthcare costs among three study cohorts: -exposures that involved Xtampza ER®, other oxycodone extended-release (ER), and oxycodone immediate-release (IR).
Study design: A real-world, observational study.
Main outcome measures: Descriptive statistics were used to describe patient and exposure characteristics. Drug utilization-adjusted rates of intentional abuse/misuse and clinical outcomes were used to determine relative risk. Healthcare cost estimates were calculated by extrapolating average charge per opioid-related disorder emergency department (ED) visit and per inpatient stay based upon case disposition rates, adjusted for population and drug utilization.
Results: Compared to Xtampza ER, exposures that involved other oxycodone ER were 7.4 times more likely to be intentional abuse/misuse, 25.9 times more likely to result in major effect or death, 9.7 times more likely to require a visit to the ED, and 14.3 times more likely to result in hospital admission. Similar results were found for oxycodone IR when compared to Xtampza ER.
Conclusions: This study is the first of its kind to synthesize clinical outcomes with opioid-related healthcare costs, suggesting that even when Xtampza ER is abused/misused, the rates of major effect/death, ED visits, and hospital admissions were significantly lower than those for other oxycodone-containing medications, resulting in relatively low downstream opioid-related healthcare costs.
期刊介绍:
The Journal of Opioid Management deals with all aspects of opioids. From basic science, pre-clinical, clinical, abuse, compliance and addiction medicine, the journal provides and unbiased forum for researchers and clinicians to explore and manage the complexities of opioid prescription.