The impact of high-risk and chronic opioid use among commercially insured endometriosis patients on health care resource utilization and costs in the United States


Endometriosis is still a poorly understood condition. At G.O. Institute we are constantly looking for the most updated information regarding endometriosis therapy. This is an very recent research paper which we hope will help you understand at least this part of endo treatment.

If this article seems to be relevant to your situation, please reach out to us and Dr. Steven Vasilev, our director. Since we are monitoring this research as it develops, we can apply it to help you beat endometriosis and get your life back.  See the “Translation” comment below the research abstract.

Womens Health (Lond). 2020 Jan-Dec;16:1745506520965898. doi: 10.1177/1745506520965898.


OBJECTIVES: Evaluate all-cause and endometriosis-related health care resource utilization and costs among newly diagnosed endometriosis patients with high-risk versus low-risk opioid use or patients with chronic versus non-chronic opioid use.

METHODS: A retrospective analysis of IBM MarketScan® Commercial Claims data from 2009 to 2018 was performed for females aged 18 to 49 with newly diagnosed endometriosis (International Classification of Diseases, Ninth Edition code: 617.xx; International Classification of Diseases, Tenth Edition code: N80.xx). Two sub-cohorts were identified: high-risk (⩾1 day with ⩾90 morphine milligram equivalents per day or ⩾1-day concomitant benzodiazepine use) or chronic opioid utilization (⩾90-day supply prescribed or ⩾10 opioid prescriptions). High-risk or chronic utilization was evaluated during the 12-month assessment period after the index date. Index date was the first opioid prescription within 12 months following endometriosis diagnosis. All outcomes were assessed over 12-month post-assessment period while adjusting for demographic and clinical characteristics.

RESULTS: Out of 61,019 patients identified, 18,239 had high-risk opioid use and 5001 chronic opioid use. Health care resource utilization drivers were outpatient visits and pharmacy fills, which were higher among high-risk versus low-risk patients (outpatient visits: 17.49 vs 15.51; pharmacy fills: 19.58 vs 16.88, p < 0.0001). Chronic opioid users had a higher number of outpatient visits (19.53 vs 15.00, p < 0.0001) and pharmacy fills (23.18 vs 16.43, p < 0.0001) compared to non-chronic opioid users. High-risk opioid users had significantly higher all-cause health care costs compared to low-risk opioid users (US$16,377 vs US$13,153; p < 0.0001). Chronic opioid users also had significantly higher all-cause health care costs compared to non-chronic opioid users (US$20,930 vs US$12,272; p < 0.0001). Similar patterns were observed among endometriosis-related HCRU, except pharmacy fills among high-risk and chronic sub-cohorts.

CONCLUSION: This analysis demonstrates significantly higher all-cause and endometriosis-related health care resource utilization and total costs for high-risk opioid users compared to low-risk opioid users among newly diagnosed endometriosis patients over 1 year. Similar trends were observed for comparing chronic opioid users with non-chronic opioid users, except for endometriosis-related pharmacy fills and associated costs.

PMID:33357086 | DOI:10.1177/1745506520965898

Stephanie J Estes

TRANSLATION:  In the United States, endometriosis is the third leading cause of gynecologic hospitalizations.  Opioid use is obviously also a very common problem in the US and is not the “right” treatment for women suffering with endo.  The treatment should be aimed at the root cause, the endometriosis, not the pain.   This includes proper surgery and targeted medical therapy.  There are a lot of comorbidities that lead to chronic opioid use and this becomes a vicious cycle.

This book by Dr. Steven Vasilev MD can help women with ovarian cysts, masses and tumors of all types, including endometriosis and endometriomas.  He is a world-renowned expert on this topic.

To discover more about endometriosis and our unique treatment approach, please READ THIS