Economic Costs of Substance Abuse Dheeraj Raina, MD Medical Director, Anthem
Annual U.S. Economic Cost of Substance Use Disorders (SUD) In $ (millions) $168 Healthcare $26 $11 $27 $79 $193 $249 $300 Crime + Lost Productivity Source: National Institute on Drug Abuse Trends and Statistics Page Accessed on May 12, 2018 $105 $204 $276 $468 Total $232 $821 $1,053 Illicit Drugs $105 Prescription opioids Alcohol $276 Tobacco $468 $204
Direct Impact of Substance Abuse on Employers Tardiness Absenteeism Presenteeism Employee Turnover Conflict
Annual Direct Cost of SUD to VA Employers 1,393 $363 $518 $512 In $ (thousands) Healthcare Job Turnover & Retraining Lost Time https://www.nsc.org/forms/substance-use-employer-calculator www.bitly.com/sudcostcalculator Total Cost of SUD to VA Employers
Indirect Impact of Substance Use Disorders on Employers Reduction in pool of potential employees Reduction in customer-base Reduction in taxpayer-base in community
Drug overdose death rates By selected age group: United States, 1999-2016
Total economic cost of Opioid epidemic since 2001 is estimated at $1 Trillion Altarum, a health systems research and consulting organization
Annual Deaths Attributed To Substance Abuse Tobacco 480,000 76% Alcohol 88,000 14% Other 63,600 10% Prescription opioids 18,000 / 3% Heroin 14,500 / 2% Fentanyl 19,500 / 3% No opioids involved 11,600 / 2% Source: CDC (drug overdose data is 2016 data)
3 Waves of the Rise in Opioid Overdose Deaths
Virginia Overdose Rates/100,000 pop In most states opioids account for about 50% of the total drug overdose deaths. For every fatal drug overdose there are 26 drug-related ER visits. 9.1 9.9 13 2.7 3.4 4.2 4.7 4.8 5.1 4.7 5.3 6.4 6.2 5.9 4.8 7.1 6.5 7.6 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 VA
Way Out Of This Epidemic Prevention Reduce prolonged exposure to prescription opioids Reduce availability of unused Rx opioids Treatment & Recovery Improve access to evidence-based treatment of addiction Deterrence Stop bad actors both on the opioid prescribing end and on the addiction treatment end. Stop the flow of illicit opioids
Anthem s Opioid Strategy Prevention Provider messaging Pharmacy point of sale edits Pharmacy home program Treatment & Recovery Expand Quality Medication Assisted Treatment (MAT) Provider & vendor collaboration Collaboration with advocacy organizations Deterrence Provider education Prevent and detect fraud, waste and abuse. Special investigations unit
What Can Be Accomplished With A Focused Strategy COMMERCIAL MEDICAID MEDICARE
What Else Is Anthem Doing? Removed prior authorization for Suboxone Committed to doubling the % of members with opioid addictions who receive quality MAT Collaborate with ECHO (Extension for Community Healthcare Outcomes) Opioid Strategy Workgroup
Why Not Just Ban All Opioids? Opioids are effective in short-term management of acute pain. Opioids are also effective for management of cancerrelated pain. For some individuals severe forms of non-cancer chronic pain will only respond to opioids. Chronic noncancer pain is not just one condition. Studies showing the efficacy of alternative treatment modalities are limited in number and quality. Inadequately treated chronic pain also has economic costs and causes mental health problems including increased risk of suicide.
All Hands On Deck! First, say no to stigma Addiction is a disease; treat it like one Improve awareness Establish pathways to effective help-seeking & evidence-based interventions Save lives first, then worry about abstinence Advocate for a public health approach to addiction Reach out and be compassionate Because
We Are All In It Together Majority of BCBS of MA members surveyed know someone addicted to opioids and over a quarter know someone who died from an overdose 46% of Americans have a friend or family member with a current or past drug addiction (PEW RESEARCH CENTER 2017) Gender Men, 46% Women, 46% Know someone ADDICTED to opioids 56% Race White, 46% Black, 52% Hispanic, 50% Know someone who has OVERDOSED on opioids 45% Age 18-29, 47% 30-49, 55% 50-64, 46% 65+, 33% Know someone who has DIED from an overdose 27% Education HS or Less, 44% Some College, 53% College Grad, 46% Post Grad, 39% Series 1 Politics Lean Dem, 46% Lean Rep, 46% Source: http://www.wbur.org/commonhealth/2018/03/12/bcbsma-opioid-survey