Healthcare Resource Use and Costs Associated with Opioid Initiation Among Patients with Newly Diagnosed Endometriosis with Commercial Insurance in the USA

Stephanie J. Estes, Ahmed M Soliman, Marko Zivkovic, Divyan Chopra, Xuelian Zhu
Advances in therapy · 2020 · vol. 37(6) , pp. 2777–2791 · doi:10.1007/s12325-020-01361-7 · PMID:32399813 · W3024261291
article OA: hybrid CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Opioid users with newly diagnosed endometriosis incurred significantly higher all-cause healthcare resource utilization and costs compared to non-opioid users over a 24-month follow-up period.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective cohort study used IBM MarketScan commercial claims data (2009–2018) to compare 24-month all-cause and endometriosis-related healthcare resource utilization and costs between women aged 18–49 with newly diagnosed endometriosis who had opioid prescriptions within 12 months after first diagnosis versus those without opioid use, using 1:1 propensity score matching. Opioid users had significantly greater all-cause healthcare utilization and higher mean all-cause costs over follow-up ($26,755 vs $19,302), with higher outpatient visits, pharmacy fills, and ER visits; endometriosis-related utilization differed by service category, with similar ER visits but lower outpatient/inpatient utilization and higher pharmacy fills among opioid users, and endometriosis-related costs showing a similar higher trend. The paper notes key limitations inherent to claims-based observational design, including reliance on coded diagnoses and prescriptions rather than clinical detail. This paper is centrally about endometriosis — it quantifies how opioid initiation after newly diagnosed endometriosis is associated with healthcare utilization and costs.

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Abstract

INTRODUCTION: To compare all-cause and endometriosis-related healthcare resource utilization (HCRU) and healthcare costs by service categories (outpatient, inpatient, emergency room [ER], pharmacy) among patients with newly diagnosed endometriosis using opioids compared to patients with endometriosis not using opioids. METHODS: A retrospective analysis of IBM® MarketScan® Commercial Claims data from 2009 to 2018 was performed for women aged 18-49 with newly diagnosed endometriosis (International Classification of Diseases (ICD)-9 code 617.xx; ICD-10 code N80.xx) over 24 months follow-up. Patients were stratified on the basis of opioid use within 12 months post first endometriosis diagnosis date. Patients with opioid use were 1:1 matched to patients without opioid use using propensity score matching. RESULTS: A total of 85,329 female patients with a new endometriosis diagnosis were identified and 48,470 patients (24,235 opioid and 24,235 non-opioid users) remained after inclusion-exclusion criteria and matching. Opioid patients had an estimated mean 30.33 outpatient visits, 29.59 pharmacy fills, 0.28 inpatient visits, 0.65 ER visits, and total length of stay (LOS) was 1.01 days. Non-opioid patients had an estimated mean 27.94 outpatient visits, 22.06 pharmacy fills, 0.23 inpatient visits, 0.42 ER visits, and total LOS was 0.82 days. On average, opioid patients had significantly greater all-cause HCRU compared to non-opioid patients (all p < 0.0001). Among endometriosis-related healthcare utilization, there were similar ER visits, but lower outpatient visits, inpatient visits, and total LOS and higher pharmacy fills among opioid and non-opioid patients. Estimated mean all-cause costs were higher among opioid ($26,755) vs. non-opioid ($19,302) users (p < 0.0001). A similar trend was observed for estimated mean endometriosis-related costs. CONCLUSION: This analysis observed significantly higher all-cause HCRU and costs for opioid users compared to non-opioid users among patients with newly diagnosed endometriosis. While observed endometriosis-related costs were significantly higher in opioid users compared to non-opioid users during a 24-month follow-up period, endometriosis-related HCRU varied by service categories for these two populations over this time period.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Analgesics, Opioid Analgesics, Opioid Endometriosis Endometriosis Health Care Costs Insurance, Health Patient Acceptance of Health Care Adolescent Adult Analgesics, Opioid Endometriosis Female Health Care Costs Humans Insurance, Health Middle Aged Patient Acceptance of Health Care Retrospective Studies United States United States

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