Opioid Abuse Adds Billions To Employers’ Health Care Costs

Analysis of claims data finds employees who abuse prescription pain meds incur higher health care costs.

It’s not just the famous or infamous who are abusing prescription pain medications. It could be the person in the next cubicle or in the office down the hall, and it’s costing your business big bucks.

That’s according to a new report from Castlight Health, a San Francisco-based health transparency company that enables employers and their employees to compare the prices and quality of care at hospitals, doctors and other health care providers.
The report, “The Opioid Crisis in America’s Workforce,” is based on an analysis of medical and pharmacy claims submitted from 2011 through 2015 by nearly 1 million employees who use the firm’s health benefits platform.

According to the analysis, 32 percent of prescriptions for opioids, which are a family of narcotic pain medications with addictive properties, are abused by patients. Castlight Health researchers defined opioid abuse as a patient receiving more than a 90-day supply of medication and receiving an opioid prescription from four or more providers over the five-year period from 2011 through 2015.

Employees who were opioid abusers during that period incurred an average of $19,450 each year in medical expenses, the analysis found. The medical expenses of employees who were not opioid abusers were $10,853, or more than 44 percent less on average per year. Castlight Health estimated that the additional expenses from opioid-abusing workers added as much as $8 billion per year to employers’ health care costs.

The analysis also ranked cities by the percentage of opioid prescriptions being abused by employees. The top 25 cities ranked by opioid prescription abuse included only one city from Minnesota. That was Rochester, home of the Mayo Clinic, where Castlight Health says 45 percent of the prescriptions written for opioids were abused by employees from 2011 through 2015.

Castlight Health recommended that employers work with their health plans to examine their own medical and pharmacy claims data regarding opioid use by their workforce. Employers could use that information to educate workers on alternative approaches to pain management, direct workers suspected of opioid abuse to providers who specialize in the treatment of opioid addiction and design medical and pharmacy benefits to mitigate the risk of opioid abuse by employees.