Study: Opioid addiction treatment costs employers $2.6B a year

A new study finds that the opioid crisis is hurting employers as spending for addiction services and overdoses has jumped nearly 1,000% since 2004. (Pixabay)

Opioid addiction has ravaged communities across the country, and it's hitting employers hard as well. 

A report by the Kaiser Family Foundation found that larger employers spent $2.6 billion to treat opioid addiction and overdoses in 2016, increasing nearly 1,000% in just 12 years. 

The report comes as private insurers are trying to find ways to cut down on opioid usage among consumers.

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

About 37% of nonelderly people with an opioid addiction are covered by private insurance, according to the report. An equal share (38%) have Medicaid coverage, and 17% have no coverage at all. 

Opioid usage has historically been associated with older Americans, and the study found that 22% of people aged 55 to 64 had at least one prescription in 2016. But opioid addiction extends well beyond adults. More than half of those employer costs went to treat employees' children in 2016. 

RELATED: Insurers take aim at curbing opioid use

Opioid use peaked in 2009 when 17.3% of large employer plan enrollees had been given at least one opioid prescription. While the cost of addiction services can be costly, federal law requires equitable insurance coverage for such treatment, but patients have sometimes needed to jump through hoops to access care.

A report last year by the Addiction Solutions Campaign found that some payers shift the cost of care to state and local governments by denying some consumers addiction service benefits and not informing them of covered treatments. 

Both insurers and the federal government have recently taken steps to cut down on the overuse of opioids among consumers. Blue Cross and Blue Shield of North Carolina has said it will limit first-time prescriptions of short-acting opioids to a maximum seven-day supply and require prior authorization for a first-time extended-release opioid. Last week, Cigna said it reduced opioid use by 25% among its members over a two-year period. 

RELATED: CMS finalizes regulations to curb opioid misuse among Part D beneficiaries

The Centers for Medicare & Medicaid Services (CMS) announced this week it is putting new limits on opioid prescriptions starting next year, including capping all new prescriptions for short-term acute pain at a 7-day supply.

Another policy change includes a ceiling of 90-milligram morphine-equivalent units for opioid prescriptions under the Part D Medicare program, which would require a pharmacist's override to fill.