Opioid Utilization Patterns Reveal an Increase in Long-Acting Opioids

The increasing opioid utilization is a growing problem. A new study aimed at understanding the utilization patterns of short-acting and long-acting opioids found that the usage of short-acting opioids has decreased over a period of time. Consequently, the usage of long-acting opioids has increased, which accounts for majority of the total opioid costs.

Prime Therapeutics LLC (Prime) undertook the research to describe utilization patterns of opioids that are short acting, long acting, have abuse deterrent formulation (ADF), and have abuse-deterrent properties (ADP). The study was conducted between January 2014 through March 2016. Pharmacy claims of almost 15 million commercially insured members were analyzed for both short- and long-acting opioids. The evaluation also included long-acting opioids with and without abuse-deterrent properties. The study found that the usage of short-acting opioids had decreased and the usage of long-acting opioids had increased.

From 20.5 million opioid claims, the study divided the opioids into 4 categories:

• non-abuse-deterrent short-acting
• non-abuse-deterrent long-acting
• abuse-deterrent with FDA validation
• abuse-deterrent without FDA validation

The following trends in each category were observed:

• Short-acting opioids decreased 4.5%
• Long-acting opioids without abuse-deterrent properties increased 2%
• Long-acting abuse-deterrent opioids with FDA validation increased 3.2%
• Long-acting abuse-deterrent opioids without FDA validation increased 26%

Overall, the increase in long-acting opioid claims slightly brought down the total opioid claims in the study period by 3.9%. These long-acting opioids accounted for 8% of all claims volume and 48.6% of total cost. Whereas, the short-acting opioids represented 92% of claims and 51.4% of cost.

Curbing the Opioid Epidemic Is Imperative

The opioid epidemic is a problem. The FDA has approved 6 ADF products. Six other products are likely to have ADP. However, these 6 products have not been granted FDA approval for label changes. Regardless, all these ADF and ADP products are long-acting opioids. It is critical for insurers to understand opioid utilization trends in order to mandate coverage of abuse deterrent formulations.

“With new laws requiring coverage of abuse-deterrent opioids, future utilization and cost trends in this category could increase,” said Cathy Starner, PharmD, principal health outcomes researcher at Prime. “It is important for insurers to understand both legislation and current utilization patterns to help forecast trend in this drug category.”

Opioids with abuse-deterrent properties are not yet proven to completely eliminate abuse. So besides cost and utilization trends, the 27-month analysis also helps focus on the relationship between ADF opioids and decreased opioid overdoses.