Just as the opioid epidemic that’s raging across the country is killing scores of individuals every year, abuse of heroin and prescription pain pills is having a similarly drastic impact on the total price tag for care.
The cost to hospitalize those with opioid abuse or dependence problems has more than tripled in a decade, up to nearly $15 billion in 2012, according to a new study published in Health Affairs this week. Similarly, the number of patients hospitalized for the effects of these drugs has surged by more than 72 percent, reaching 520,000 in 2012 (the year with the most recent available data), researchers with Harvard and the Veteran’s Health Administration found. Overall hospitalizations during that time, meanwhile, stayed relatively flat.
Those skyrocketing numbers correspond with the surge in overdose deaths from heroin and painkillers, which reached a high-water mark at more than 28,000 in 2014, according to the Centers for Disease Control and Prevention.
The numbers are “astronomical,” says Matt Ronan, M.D., co-author of the study and a hospitalist in general internal medicine at the VA’s West Roxbury Medical Center in Boston.
“What is even more compelling is the fact that private insurance is only covering a small subset of that,” says Ronan, who is also a professor at Harvard Medical School. The burden is really being carried by the hospitals, the patients and the government programs.”
An average hospital stay for an opioid abuse patient cost about $28,000 in 2012, and only about 20 percent of discharges related to those incidents were covered by private insurance, researchers found. The number leaps to $107,000 if there was an associated infection, with about 14 percent covered by insurance. Typically, Medicaid was the most common insurance status for patients hospitalized for an opioid issue.
Researchers with Harvard and the VA found these numbers by digging through 2002 to 2012 data used by the Agency for Healthcare Research and Quality for its Cost Utilization Project. It’s possible that costs for treating these patients were even higher than $15 billion, the study notes, as they did not factor in when a patient is discharged back home for a long course of antibiotics and visiting-nurse services.
Ronan says that the study’s authors wanted to take a closer look at incidences of infection stemming from intravenous drug use, which has been a relatively unexplored aspect of the opioid epidemic. One of the biggest takeaways for hospital leaders, he believes, is the importance of education for both patients and providers. For the former, that includes instituting needle exchange programs to help avoid infections, supplying patients and their families with naloxone to treat overdoses, encouraging sterile injection techniques if patients can’t quit heroin, and spreading the word about detox programs.
“The biggest way to impact the cost and the burden on the health care system is preventative measures, looking at opioid abuse and dependence as a chronic illness, much like primary and secondary prevention for other chronic diseases,” Ronan says. “The best way to prevent downstream complications is to prevent the primary problem.”