With deaths from opioid overdose rising steeply in recent years, and a large segment of the population reporting knowing someone who has been addicted to prescription painkillers, the breadth of the opioid crisis should come as no surprise, affecting people across all incomes, ages, and regions. About four in ten people addicted to opioids are covered by private health insurance and Medicaid covers a similarly large share.
Private insurance covers nearly 4 in 10 non-elderly adults with opioid addiction
Insurance status of non-elderly adults with opioid addiction, 2016:
*38% Medicaid, 37% Private Insurance, 17% Uninsured, & 8% Unknown
Source: Kaiser Family Foundation analysis of the 2016 National Survey on Drug Use and Health*
In this analysis and a corresponding chart collection, we use claims data from large employers to examine how the opioid crisis has affected people with large employer coverage, including employees and their dependents. The analysis is based on a sample of health benefit claims from the Truven MarketScan Commercial Claims and Encounters Database, which we used to calculate the amounts paid by insurance and out-of-pocket on prescription drugs from 2004 to 2016. We use a sample of between 1.2 and 19.8 million enrollees per year to analyze the change from 2004 to 2016 in opioid-related spending and utilization.
We find that opioid prescription use and spending among people with large employer coverage increased for several years before reaching a peak in 2009. Since then, use of and spending on prescription opioids in this population has tapered off and is at even lower levels than it had been more than a decade ago. The drop-off in opioid prescribing frequency since 2009 is seen across people with diagnoses in all major disease categories, including cancer, but the drop-off is pronounced among people with complications from pregnancy or birth, musculoskeletal conditions, and injuries.
Written by Cynthia Cox, Matthew Rae, & Bradley Sawyer, Kaiser Family Foundation
