Drug Safety and Abuse Sep 15, 2013

Patterns of Narcotic Use and Abuse

At the ISPOR conference, Express Scripts presented new data identifying cost and utilization patterns for prescription narcotic use in the U.S.

When taken as prescribed, narcotic medications can help relieve acute and chronic pain. But given their potential for abuse, close monitoring and management of their use is critical to ensure better health and lower costs.

Express Scripts research being presented this week at the 17th annual ISPOR conference provides insight into the use of narcotics based on age, gender and geographic location of patients. Our study examined the prevalence, utilization and cost trend of narcotics in 2010, using pharmacy claims for commercially insured patients. per member per year utilization by state

Key findings of the study include:

  • Women filled more narcotic prescriptions than men.
  • However, men used more expensive narcotic prescriptions and had lower generic fill rates (GFR).
  • Men and women in the 25-34 age groups had the largest difference in cost-per-prescription.
  • New Jersey had the lowest generic fill rate, contributing to a higher cost per prescription.
  • On average for those age 75 and older, more was spent on narcotics for women than for men.
  • The center of the country – with the exception of Oklahoma – spent less per capita on narcotics than the Eastern or Western regions did.
  • Alabama, Oklahoma, Tennessee, Mississippi, and West Virginia had the highest narcotic utilization rates.
  • Oklahoma, Nevada, Utah, Ohio, and Alabama had the highest per capita spending on narcotics (factoring in both utilization and cost-per-prescription).
cost per prescription by state

Why Does It Matter?

Abuse of prescription narcotics is a major problem in the U.S., responsible for 1.2 million emergency room (ER) visits in 2009 alone. An estimated 9,000 Americans begin abusing prescription narcotics each day and as of 2007, 35 million people – 14% of the population – reported having abused these medications at some point in their lives.

Abuse also has a high financial cost. Those who abuse narcotics are 2.3 times more likely to visit an ER than non-abusers. Pharmacy costs for abusers are 5 to 7 times greater than those for non-abusers.

Narcotics also have a potential for dependency through what are called reinforcing effects: reduced anxiety, boredom and aggression, and increased feelings of pleasure. According to the Centers for Disease Control, narcotic prescription overdoses accounted for nearly 15,000 deaths in 2008, a four-fold increase since 1999.



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