Manager, Analysis Group, Inc., Boston, MA.
Postgrad Med. 2014 Jul;126(4):53-8. doi: 10.3810/pgm.2014.07.2783.
The abuse of prescription opioids imposes a substantial public health and economic burden. Recent research using administrative claims data has substantiated the prevalence and cost of opioid abuse among commercially insured individuals. Although administrative claims data are readily available and have been used to effectively answer research questions about the burden of illness for many different conditions, an important issue is the reliability, replicability, and generalizability of estimates derived from different databases. Therefore, this study sought to assess whether the findings of a recently published study of opioid abuse in a commercial claims database (original analysis) could be replicated in a different commercial claims database. The original analysis, which analyzed the prevalence and excess health care costs of diagnosed opioid abuse in the OptumHealth Reporting and Insights Database, was replicated by applying the same approach to the Truven MarketScan Commercial Claims and Encounters Database (replication analysis). In the replication analysis, the prevalence of diagnosed opioid abuse increased steadily from 15.8 diagnosed opioid abusers per 10,000 in 2009, to 26.6 diagnosed opioid abusers per 10,000 in 2012. Although the prevalence of diagnosed opioid abuse was higher than reported in the original analysis, the trend of increasing prevalence over time was consistent across analyses. Additionally, diagnosed abusers had excess annual per patient health care costs of $11,376 in the replication analysis, which was consistent with the excess annual per patient health care costs of diagnosed abuse of $10,627 reported in the original analysis. The replication analysis also found an upward trend in the prevalence of diagnosed opioid abuse over time and substantial excess annual per patient health care costs of diagnosed opioid abuse among commercially insured individuals, suggesting that these findings are generalizable to other commercially insured populations.
处方阿片类药物的滥用给公共健康和经济带来了巨大的负担。最近利用行政索赔数据进行的研究证实了商业保险个人中阿片类药物滥用的流行率和成本。尽管行政索赔数据易于获得,并已被用于有效地回答许多不同疾病的疾病负担研究问题,但一个重要的问题是不同数据库中得出的估计值的可靠性、可重复性和通用性。因此,本研究旨在评估在商业索赔数据库中最近发表的一项关于阿片类药物滥用研究的结果(原始分析)是否可以在另一个商业索赔数据库中复制。原始分析分析了 OptumHealth Reporting 和 Insights 数据库中诊断为阿片类药物滥用的流行率和过度医疗保健成本,通过在 Truven MarketScan 商业索赔和遭遇数据库(复制分析)中应用相同的方法来复制该分析。在复制分析中,诊断为阿片类药物滥用的患病率从 2009 年每 10000 人中有 15.8 名诊断为阿片类药物滥用者稳步增加到 2012 年每 10000 人中有 26.6 名诊断为阿片类药物滥用者。虽然诊断为阿片类药物滥用的患病率高于原始分析报告,但随时间推移患病率上升的趋势在两个分析中是一致的。此外,在复制分析中,诊断为滥用者的每位患者每年的医疗保健费用为 11376 美元,与原始分析报告的 10627 美元诊断滥用的每位患者每年的医疗保健费用过高相符。复制分析还发现,随时间推移,诊断为阿片类药物滥用的患病率呈上升趋势,商业保险个人中诊断为阿片类药物滥用的每位患者每年的医疗保健费用也存在大量过剩,这表明这些发现可推广到其他商业保险人群。