Narcotics in Commercially-Insured Americans

Jun 1, 2012

Use of Narcotic Medications Among a Large Commercially-Insured Population in the United States.Published in Value in Health.


Objectives: Narcotic medications are increasingly becoming the most-abused medicines in the United States, accounting for hundreds of deaths and thousands of emergency room visits. The objective of this study is to examine the use of narcotic medications in a commercially insured population.

Methods: Retrospective pharmacy claims from a large US pharmacy benefit manager between January 2010 to December 2010 examined the prevalence, utilization and cost trend of narcotic medications (GPI2=65). Only commercially insured patients with integrated and funded prescription benefits were included in the analysis.

Results: While females filled more narcotic prescriptions than males, male patients used more expensive narcotic medications than their female counterparts ($58 per script and $45 per script, respectively). The largest difference in cost per prescription between males and females was in the 25-34 age groups ($64 per script and $33 per script for male and female, respectively). Within this age group, males spent 42% of their overall narcotic cost on Suboxone® and 16% on Oxycontin®, whereas females only spent 21% on Suboxone®, 15% on hydrocodone-acetaminophen, and 14% on Oxycontin®. Males had lower generic fill rate (GFR) compared to their female counterparts (86% and 95%, respectively). Consequently, the Per Member per Year (PMPY) narcotic cost for males was $13.04 higher than females 24-35 years of age. As patient age increases, however, the trend is reversed: female PMPY narcotic cost is $19.35 higher than male counterparts aged 75 or older. The utilization and cost of narcotic medications differ by geographic region with Oklahoma, Nevada, Utah, Ohio, and Alabama ranked as the Top 5 most costly and Alabama, Oklahoma, Tennessee, Mississippi, and Wyoming having the highest utilization.

Conclusions: Results from this analysis can provide insights into the utilization and cost of narcotic medications.