Methadone maintenance and the cost and utilization of health care among individuals dependent on opioids in a commercial health plan

Dennis McCarty, Nancy A. Perrin, Carla A. Green, Michael R. Polen, Michael C. Leo, Frances Lynch

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: Few health plans provide maintenance medication for opioid dependence. This study assessed the cost of treating opioid-dependent members in a commercial health plan and the impacts of methadone maintenance on costs of care. Methods: Individuals with diagnoses of opioid dependence (two or more diagnoses per year) and at least 9 months of health plan eligibility each year were extracted from electronic health records for the years 2000 through 2004 (1,518 individuals and 2,523 observations across the study period-some individuals were in multiple years). Analyses examined the patterns and costs of health care for three groups of patients: (1) one or more methadone visits during the year (n= 1,298; 51%); (2) no methadone visits and 0 or 1 visits in the Addiction Medicine Department (n= 370; 15%); (3) no methadone visits and 2 or more visits in addiction medicine (n= 855; 34%). Results: Primary care (86%), emergency department (48%) and inpatient (24%) visits were common. Mean total annual costs to the health plan were $11,200 (2004 dollars) per member per year. The health plan's costs for members receiving methadone maintenance were 50% lower ($7,163) when compared to those with two or more outpatient addiction treatment visits but no methadone ($14,157) and 62% lower than those with one or zero outpatient addiction treatment visits and no methadone treatment ($18,694). Conclusions: Use of opioid maintenance services was associated with lower total costs of care for opioid-dependent members in a commercial health plan.

Original languageEnglish (US)
Pages (from-to)235-240
Number of pages6
JournalDrug and Alcohol Dependence
Volume111
Issue number3
DOIs
StatePublished - Oct 1 2010

Keywords

  • Commercial health insurance
  • Cost analysis
  • Health care utilization
  • Methadone maintenance
  • Parity

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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