OBJECTIVE: To assess prescription opioid use and associated cost burden among children and adolescents with asthma in the United States (US) using a nationally representative database.
METHODS: Using 2011 to 2015 Medical Expenditure Panel Survey (MEPS) data, a cross sectional study was conducted among children and adolescents with asthma treated with a prescription opioid. Survey design methods were used to generate national estimates of prescription opioid use and all-cause total healthcare and pharmacy-related expenditures. Key background characteristics that were assessed included patient demographics, type of opioid prescription, and medical diagnosis (grouped by cardiorespiratory, dental, ear-nose-throat, gastrointestinal, hematologic/oncologic, infection, neurologic and migraine, non-traumatic orthopedic, skin/dermatological, urogenital, and trauma) associated with opioid prescription. All cost data were adjusted to 2017 US dollars using the medical care component of the US Consumer Price Index.
RESULTS: Prescription opioids were received by an estimated 4.2% (95% CI, 3.2%-5.2%) of children and adolescents with asthma as compared to 2.4% (95% CI, 2.2%-2.7%) of patients without asthma (p-value, <0.0001). The most common opioids prescribed were hydrocodone, codeine, tramadol, and oxycodone. The most common diagnoses associated with opioid prescriptions were trauma (22.0%) and cardiorespiratory conditions (18.8%). Among asthma patients, the average total health care expenditure for opioid users was $9,761 (95% CI, $4,740-$14,781) per patient versus $4,762 (95% CI, $3,222-$6,302) for non-opioid users; prescription costs did notvary greatly by opioid use status.
CONCLUSIONS: From 2011-2015, a significantly greater proportion of children and adolescents with asthma were prescribed opioids compared to those without asthma. These findings may indicate yet another area and special population of potential concern (children and adolescents with a common respiratory disease) in the ongoing opioid crisis in the US that requires urgent attention by policy makers, providers, patients, and other healthcare stakeholders.
