Ghate Sameer R, Haroutiunian Simon, Winslow Roger, McAdam-Marx Carrie
Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah 84108, USA.
J Pain Palliat Care Pharmacother. 2010 Sep;24(3):251-8. doi: 10.3109/15360288.2010.501851.
Opioid abuse places a large burden on the U.S. society. Two similarly designed studies recently identified the economic and health impact of opioid abuse in patients with private or Medicaid insurance. The prevalence of opioid abuse was estimated to be over 10 times higher in Medicaid beneficiaries than private insurance populations, 87 versus 8 per 10,000, respectively. Opioid abusers incurred annual medical costs that were $14,054 to $6650 higher than nonabusers in patients with private insurance or Medicaid beneficiaries, respectively (P < .01 for both). Annual costs were similar for abusers with private insurance ($15,884) or Medicaid beneficiaries ($13,658). Costs for nonabuser Medicaid beneficiaries were $7008 versus $1830 for those with private insurance, which likely reflects the lower health status of the overall Medicaid population. In both studies, the prevalence of comorbidities associated with substance abuse or chronic pain were significantly higher in abusers than nonabusers. These studies confirm that opioid abuse is associated with comorbidities that increase direct medical costs for patients with private insurance and for Medicaid beneficiaries, increasing the societal burden of opioid abuse.
阿片类药物滥用给美国社会带来了沉重负担。最近两项设计相似的研究确定了阿片类药物滥用对拥有私人保险或医疗补助保险患者的经济和健康影响。据估计,医疗补助受益人群中阿片类药物滥用的患病率比拥有私人保险人群高出10倍以上,分别为每10000人中有87人和8人。阿片类药物滥用者每年产生的医疗费用分别比拥有私人保险的患者或医疗补助受益人群中的非滥用者高出14,054美元至6650美元(两者P均<0.01)。拥有私人保险的滥用者(15,884美元)和医疗补助受益人群(13,658美元)的年度费用相似。医疗补助非滥用受益人的费用为7008美元,而拥有私人保险的非滥用者为1830美元,这可能反映了整个医疗补助人群较低的健康状况。在两项研究中,与药物滥用或慢性疼痛相关的合并症在滥用者中的患病率均显著高于非滥用者。这些研究证实,阿片类药物滥用与合并症相关,这些合并症增加了拥有私人保险的患者和医疗补助受益人的直接医疗费用,加重了阿片类药物滥用的社会负担。