ANOVA - Knowledge Translation Consulting Group, Rio de Janeiro, Brazil.
Value Health. 2011 Jul-Aug;14(5 Suppl 1):S78-81. doi: 10.1016/j.jval.2011.05.019.
To estimate the prevalence of constipation concomitant to opioid treatment and related resource use and costs from the private payer perspective.
In this retrospective database analysis, patients receiving opioid therapy were identified from a longitudinal insurance claims database. An algorithm was used to identify patients receiving opioid therapy with coincident constipation-related claims according to ICD-10 codes, targeted procedures, and opioid use criteria. Resource use and costs were determined for these individuals and compared with patients receiving opioid therapy without constipation, without opioid therapy with constipation, and without both conditions. Results were compared using analysis of variance with a significance level of 0.05.
A total of 23,313 patients were classified as opioid-treated patients (2.2%) and 6678 of them had events related to constipation (29.0%). Compared with opioid-treated patients without constipation, incremental mean total costs per month per patient were 261.18 BRL (P < 0.001). The average cost per month for opioid-related constipation patients was 787.84 BRL, significantly higher than other patients (P < 0.001 for all comparisons). Among cancer patients, 24.4% was receiving opioids and 27.0% of those had constipation-related claims. As expected, the opioid therapy prevalence was significantly higher when compared to all patients (2.2% vs. 24.4%, P < 0.001). Cancer patients had, in average, higher costs than did noncancer patients in all four subgroups.
Patients with constipation coincident with opioid treatment exhibited a significantly higher economic burden than did patients without the condition. These results indicate that reducing opioid-induced constipation could lead to potential cost savings for the health care system.
从私人支付者的角度估计阿片类药物治疗伴随的便秘的患病率以及相关资源的使用和成本。
在这项回顾性数据库分析中，从纵向保险索赔数据库中确定接受阿片类药物治疗的患者。根据 ICD-10 代码、靶向程序和阿片类药物使用标准，使用算法来识别接受阿片类药物治疗且伴有便秘相关索赔的患者。确定这些个体的资源使用和成本，并与接受阿片类药物治疗而无便秘的患者、接受阿片类药物治疗而无便秘的患者以及无这两种情况的患者进行比较。使用具有 0.05 显著性水平的方差分析比较结果。
共有 23313 名患者被归类为接受阿片类药物治疗的患者（2.2%），其中 6678 名患者有与便秘相关的事件（29.0%）。与无便秘的接受阿片类药物治疗的患者相比，每位患者每月的总增量费用平均为 261.18 巴西雷亚尔（P < 0.001）。阿片类药物相关便秘患者的平均每月费用为 787.84 巴西雷亚尔，显著高于其他患者（所有比较均 P < 0.001）。在癌症患者中，24.4%正在接受阿片类药物治疗，其中 27.0%的患者有便秘相关的索赔。不出所料，与所有患者相比，阿片类药物治疗的患病率显著更高（2.2%比 24.4%，P < 0.001）。在所有四个亚组中，癌症患者的平均费用均高于非癌症患者。
与阿片类药物治疗伴随的便秘患者表现出明显更高的经济负担，这表明减少阿片类药物引起的便秘可能会为医疗保健系统节省潜在的成本。
