Opioid crisis: Insurers bear brunt of cost burden

As the opioid abuse and addiction crisis intensified, private and public insurers took on more of the cost, according to new research from the Centers for Disease Control and Prevention published in Health Affairs.

Out-of-pocket spending on opioids fell dramatically, from $4.40 per 100 morphine milligram equivalents to $0.90, according to the analysis of data from the Medical Expenditure Panel Survey between 1999 and 2012.

Instead, public and private insurers picked up a greater share of the costs. Medicare is the largest payer for opioid pain relievers, according to the study. Since the implementation of Medicare Part D in 2006, Medicare has covered up to 30 percent of the cost of the drugs.

Medicare has also paid considerably more per patient for such drugs than private payers or Medicaid, according to the research. Per capita spending also varied significantly by age group, with Medicare spending for patients between 45 and 64 much higher than for older beneficiaries and also higher than expenditures for any age group among other payers.

The researchers attributed the increased spending to a potential shift in prescription benefits among "dual eligibles" receiving both Medicare and Medicaid benefits, particularly post-Medicare Part D.  "Given that Medicare spending for opioids among patients younger than age sixty-five has exceeded Medicaid spending for opioids since 2006," they wrote, "disabled Medicaid enrollees receiving their prescription benefits through Medicare Part D likely represent a large percentage of Medicaid recipients who are prescribed opioids."

To learn more:
- read the study abstract

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