Friday, April 19, 2019

In last decade, cost of opioid-related treatment at UK rose 733% and number of opioid patients rose 481%

There are several ways to measure the depth of the opioid epidemic that has spread across Kentucky and much of the nation in the past decade; the most common is the number of overdose deaths,which rose from 1,010 in 2013 to 1,565 in 2017.

The most recent measuring stick is the cost of hospital treatment at the University of Kentucky for problems related to opioid addiction. It went up more than 700 percent from 2009 to 2018, reports Linda Blackford of the Lexington Herald-Leader, who got UK to run the numbers.

In 2009, UK's A.B. Chandler Hospital and Good Samaritan Hospital treated about 1,500 people for opioid-related issues, "ranging from overdoses to blood infections to hepatitis C," Blackford writes. "The cost of those treatments: $7.6 million. By 2018, the number of patients treated for problems caused by opioid addiction had skyrocketed 481 percent to 8,782 and the cost had soared 733 percent to $63.3 million."

According to the data compiled by UK, about 54 percent of the bill was paid by Medicaid, 19 percent is by Medicare "and the rest by private insurers or the patient," Blackford writes. "Figures from the Kentucky Cabinet for Health and Family Services show that 63,000 Kentucky Medicaid patients were diagnosed with opioid use disorder in 2018. The agency estimates the annual per capita cost to treat each of those patients tops $15,000. Using a conservative estimate, that’s almost $1 billion a year from federal and state coffers." The federal government pays 75 to 80 percent of the cost.

"The numbers, while jaw-dropping, are just one small but instructive sliver of the real cost this epidemic is demanding of state and federal coffers as it decimates Kentucky families and communities with one of the highest overdose death rates in the nation," Blackford writes.

“This is just the tip of the iceberg,” Sharon Walsh, executive director of the UK Center for Drug and Alcohol Research, told the Herald-Leader.

Blackford reports: "For UK, which serves as the regional hub for complex medical care for the eastern half of the state, the opioid crisis has affected nearly every facet of health care delivery," from reworking emergency-room procedures to tightening pain-control protocols. "Many doctors now recognize that the crisis was fueled by the over-prescription of pain pills that turned out to be far more addictive than they realized," Blackford notes.

UK collected $264 million in the decade for treating the effects of the epidemic, and has used part of that money to improve its treatment, such as "a special neonatal intensive care area for babies born addicted to opioids. They now stay longer in the hospital with their moms, which is a big expense. From 2009 to 2015, the annual costs for neonatal abstinence syndrome went from about $1.4 million to more than $6.1 million. In recent years, that number has dropped slightly."

The Herald-Leader offers caveats about the data: "The numbers provided by UK only account for in-patient and out-patient treatment . . . and includes only those patients whose billing codes included opioids. They don’t include UK physician visits or the numerous clinics and programs where doctors and counselors work with substance abuse disorder patients. . . . Billing codes are an imperfect way to track opioid-use disorder because many physicians might not include it as part of a diagnosis if a patient is seeing them for a seemingly unrelated disorder."

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