Systemic opioid elimination after implantation of an intrathecal drug delivery system significantly reduced health-care expenditures
| Autor: | Amanda R. Ernst, John A. Hatheway, Guy David, David Caraway, Michael Saulino, Jennifer Hinnenthal, Candace Gunnarsson |
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| Rok vydání: | 2014 |
| Předmět: |
Drug
Adult Male Time Factors Adolescent Databases Factual media_common.quotation_subject Pain Pharmacy Intrathecal Young Adult Age Distribution Drug Delivery Systems Health care medicine Humans Child media_common Aged Retrospective Studies Aged 80 and over Analgesics business.industry Chronic pain Infant Newborn Infant General Medicine Middle Aged medicine.disease Analgesics Opioid Anesthesiology and Pain Medicine Neurology Opioid Anesthesia Child Preschool Drug delivery Female Neurology (clinical) Implant Health Expenditures business Delivery of Health Care medicine.drug |
| Zdroj: | Neuromodulation : journal of the International Neuromodulation Society. 18(3) |
| ISSN: | 1525-1403 |
| Popis: | Objective To compare health-care expenditures over a 12-month horizon for chronic pain patients with implanted intrathecal drug delivery systems (IDDS) who eliminated or continued systemic opioids postimplant. Methods Claims data from commercial and Medicare databases were searched for patients who had an IDDS, used systemic opioids before implant, and had 12 months pre- and 13 months postimplant continuous medical and pharmacy coverage. The number and characteristics of patients who eliminated or continued systemic opioids were determined at four times postimplant: 30 days (allowing a systemic opioid washout period), 120 days, 150 days, and 210 days. Multivariable models evaluated the effect of eliminating opioids on health-care expenditures at each of those times. Results Three hundred eighty-nine patients met inclusion criteria, and 51% completely eliminated systemic opioids (12% within the 30-day washout and an additional 39% by the end of the one-year horizon). Systemic opioid elimination within 120 to 210 days postimplant was associated with a reduction of $3,388 to $4,465 in inpatient and outpatient expenditures, and $4,689 to $5,571 in inpatient, outpatient, and drug expenditures. Conclusions Fifty-one percent of patients completely eliminated systemic opioids in the year after IDDS implant. This elimination resulted in a 10% to 17% reduction in yearly inpatient, outpatient, and drug expenditures. |
| Databáze: | OpenAIRE |
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