Use of Prescription Opioids Decreased While Costs and Overdoses Increased
The largest single-year drop in prescription Opioid use was recorded in 2018, according to a new report by IQVIA Institute for Human Data Science. Use declined by 17.1% in the US, buoyed by federal lawsuits against a number of Opioid manufacturers and distributors. The study showed Americans averaged 34 pain pills (such as Vicodin® or Oxycodone) per adult. Conversely, in 1992, adults used an average of 22 painkillers. In 2011, the highest rate recorded, adults used an average of 72 pills.
Decreases in prescription Opioid volume have been driven by changes in clinical use, regulatory and reimbursement policies and legislation that has been increasingly restricting prescription Opioid use since 2012.
Medicine Use and Spending in the U.S., 2019
The positive news comes after back-to-back months of the successful prosecution of individuals and entities which profited from the Opioid Epidemic. A federal jury found four high-ranking executives from Insys Therapeutics (makers of Fentanyl spray, Subsys®) and founder John Kapoor guilty of racketeering a conspiracy. Moreover, Rochester Drug Cooperative has been charged with felony drug trafficking, Purdue Pharma continues to pay settlements in the hundreds of millions of dollars, and companies like CVS and Johnson & Johnson face similar lawsuits.
Rising Prescription Costs
While use of prescription Opioids is down, the IQVIA report showed that the total number of prescriptions in the country increased – up 2.7% from 2017. Likewise, out-of-pocket costs for prescriptions increased by more than $2 billion in 2017. Total out-of-pocket costs were approximately $61 billion in 2018, up $5 billion from 2014. Perhaps in response to rising costs, more “commercially insured” patients (19%) are using coupons to offset higher costs for brand name medication.
Fentanyl and Tramadol Causing More Deaths
Despite the optimistic fall in use of prescription Opioids, overdose deaths continue to increase. Since 2011, use of prescription Opioids has fallen by 43%, yet 46 people die each day from an overdose involving prescription Opioids. Prescription Opioids are involved in more than a third of all Opioid-involved deaths.
According to the Centers for Disease Control and Prevention (CDC), the most common prescription Opioids involved in drug deaths are:
- Methadone
- Oxycodone (OxyContin®, Percocet®)
- Hydrocodone (Vicodin®)
However, authorities now warn that the biggest Opioid threat comes from synthetic Opioids like Fentanyl and Tramadol. In 2017, synthetic Opioids were involved in more overdose deaths than any other category of Opioid – over 28,000 deaths. Deaths involving synthetic Opioids have climbed in all demographics (age, race, et cetera), across rural and urban communities, and in various states.