Inocencio Timothy J, Carroll Norman V, Read Edward J, Holdford David A
Avalere Health, Washington, DC.
Pain Med. 2013 Oct;14(10):1534-47. doi: 10.1111/pme.12183. Epub 2013 Jul 10.
To estimate the yearly economic burden of opioid-related poisoning in the United States.
Rates of opioid poisoning and related mortality have increased substantially over the past decade. Although previous studies have measured the costs of misuse and abuse, costs related specifically to opioid poisoning have not been quantified. This study quantifies the economic burden of opioid poisoning in the United States to help evaluate the economic case for efforts to reverse or prevent opioid poisoning and its associated morbidity and mortality.
Mean costs and prevalence estimates were estimated using publically available datasets. A societal perspective was assumed and accordingly estimated direct medical and productivity costs. Direct medical costs included treatment for opioid poisoning in the emergency department (ED) and inpatient settings, along with emergency transport and drug costs. Productivity costs were estimated using the human capital method and included lost wages due to mortality and absenteeism costs from ED visits and hospitalizations. All costs were inflated to 2011 U.S. dollars.
In 2009, total costs were estimated at approximately $20.4 billion with indirect costs constituting 89% of the total. Direct medical costs were approximately $2.2 billion. ED costs and inpatient costs were estimated to be $800 million and $1.3 billion, respectively. Absenteeism costs were $335 million and lost future earnings due to mortality were $18.2 billion.
Opioid-related poisoning causes a substantial burden to the United States each year. Costs related to mortality account for the majority of costs. Interventions designed to prevent or reverse opioid-related poisoning can have significant impacts on cost, especially where death is prevented.
评估美国阿片类药物相关中毒的年度经济负担。
在过去十年中,阿片类药物中毒率及相关死亡率大幅上升。尽管此前的研究已衡量了药物滥用的成本,但与阿片类药物中毒具体相关的成本尚未得到量化。本研究对美国阿片类药物中毒的经济负担进行量化,以助力评估为扭转或预防阿片类药物中毒及其相关发病率和死亡率所做努力的经济合理性。
使用公开可用数据集估算平均成本和患病率。采用社会视角,据此估算直接医疗成本和生产力成本。直接医疗成本包括急诊科(ED)和住院环境中阿片类药物中毒的治疗费用,以及紧急运输和药物成本。生产力成本采用人力资本法估算,包括因死亡导致的工资损失以及急诊就诊和住院的旷工成本。所有成本均按2011年美元进行通胀调整。
2009年,总成本估计约为204亿美元,其中间接成本占总成本的89%。直接医疗成本约为22亿美元。急诊科成本和住院成本估计分别为8亿美元和13亿美元。旷工成本为3.35亿美元,因死亡导致的未来收入损失为182亿美元。
阿片类药物相关中毒每年给美国造成巨大负担。与死亡相关的成本占成本的大部分。旨在预防或扭转阿片类药物相关中毒的干预措施可对成本产生重大影响,尤其是在预防死亡方面。