Employers Pay As 32% of Opioid Prescriptions Are Abused: Report

Nearly one out of every three (32 percent) opioid prescriptions, which are subsidized by America’s employers, is being abused, according to a report by a healthcare data and technology company.

San Francisco-based Castlight Health Inc. released the study, “The Opioid Crisis in America’s Workforce,” which also found that nationally on average 4.5 percent of individuals who have received an opioid prescription are abusers and account for 32 percent of total opioid prescriptions and 40 percent of opioid prescription spending.

Opioid abusers cost employers nearly twice as much ($19,450) in medical expenses on average annually as non-abusers ($10,853), according to the analysis.

“The personal impact that opioid painkiller abuse takes on individuals, their friends and family is absolutely tragic,” said Kristin Torres Mowat, senior vice president of health plan and strategic data operations at Castlight Health. “This crisis is also having a significant impact on the nation’s employers, both in the form of direct and indirect costs. From higher spending on healthcare, to lost productivity, to the dangers associated with employees abusing medications in the workplace— these are aspects of the crisis that are too often overlooked in the current discussion.”

In 2011, the American Academy of Pain Medicine published a report by researchers at The Analysis Group in Boston and King Pharmaceuticals in North Carolina that tallied the U.S societal costs of prescription opioid abuse. The study said workplace costs accounted for $25.6 billion — including lost earnings from premature death ($11.2 billion) and reduced compensation/lost employment ($7.9 billion). It also found that the costs to the healthcare system were close to $25 billion, while the costs to the criminal justice system were about $5 billion.

The Castlight report is one on a growing list of studies pointing to the high cost of prescription drug and opiod abuse in the workplace, including to the workers’ compensation system.

A 2012 study in the Journal of Occupational & Environmental Medicine found that when long-acting opioid painkillers are prescribed, workers’ compensation claims are nearly four times more likely to turn into catastrophic claims with costs tallying more than $100,000.

About 80 percent of officials at 200 Indiana companies surveyed in 2015 by the National Safety Council reported that they’ve had problems with workers abusing or misusing prescription medications, including opioid painkillers such as Vicodin and OxyContin.

According to research into physician dispensing of opioids, the Workers Compensation Research Institute (WCRI) reported that three out of four injured workers with pain are prescribed opioids, with the amount per claim varying by state.

A recent report by pharmacy benefits manager Express Scripts suggested the cost of opioids to workers’ compensation may be slowing. At $450.90 per-user-per-year, opioids continue to be the costliest class of medications for occupational injuries, Express Scripts found, but overall spending for opioids decreased nearly 5 percent as utilization decreased by almost 11 percent. On average, injured workers received 2.91 opioid prescriptions per year – down from 3.33 prescriptions in 2014.

Castlight Findings

Additional insights reported by Castlight in its report include:

Baby boomers are nearly four times more likely (7.4 percent) to abuse opioids than Millennials (2 percent).
Patients living in areas with lower incomes are twice as likely to abuse prescription painkillers as individuals in high-income areas. Additionally, opioid abusers are more likely to live in the rural South. Overall, 22 out of the top 25 U.S. cities for opioid abuse are primarily rural and located in Southern states.
Among the top 30 largest U.S. cities, eight have higher than average opioid abuse rates. The cities include Las Vegas (7.4 percent), Charlotte (6.2 percent), Kansas City (5.1 percent) Portland (5.0 percent), Tampa (5.0 percent), Indianapolis (4.9 percent), Orlando (4.6 percent), and San Antonio (4.6 percent).
Among the top 30 largest U.S. cities, eight have a higher percentage of opioid prescriptions abused than the national benchmark of 32 percent. These cities include Charlotte (44 percent), Las Vegas (41 percent), Kansas City (38 percent), Portland (38 percent), Tampa (37 percent), Indianapolis (35 percent), Chicago (33 percent), and Dallas (33 percent).

The Centers for Disease Control and Prevention (CDC) has called this issue a public health crisis. According to the CDC, nearly 2 million Americans are abusing prescription opioids, resulting in over 16,000 deaths per year.

In 2012, 259 million opioid prescriptions were written, enough for every American adult to a bottle of pills.

For its report, Castlight Health, which offers a platform that allows employees to choose and manage their healthcare, conducted research on opioid abuse based on aggregated reporting from medical and pharmacy-based claims. These findings include nearly one million Americans who use Castlight’s health benefits platform, a subset of Castlight’s broader user population. The study is based on Castlight’s medical and pharmacy reporting over the five-year period from 2011-2015.

Castlight analyzed its data across demographic categories, including age, income and geography. In addition, Castlight looked at 2015 annual medical healthcare spend associated with this dataset.