Opioids: How Analytics Can Help Identify & Fight the Costs

Nearly every day it seems like opioid addiction is in the news media in one way or another, and for good reason, as it’s an issue that more and more Americans are struggling with every day. According to the National Institute on Drug Abuse, “roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them” and of those, between “8 and 12 percent develop an opioid use disorder.”

With numbers like these, it’s imperative for employers to measure and track this issue (or the potential issue) in those persons covered under their plans (after all, 14 percent of enrollees with large employer coverage have some sort of opioid prescription, opening the door for addiction problems).

It might seem like a task that’s too large, or even impossible, for an employer to take on… but with data and analytics, it’s not.

Taking into account employees/enrollees suffering from things like advanced stage cancer or terminal illness, using data and analytics to review member information can find:

  • Members that have prescriptions for opioids but not doctor’s visits in the same time frame (Indicating medical management problem – is a physician the member knows personally prescribing the medication? Is the prescription a re-fill without a follow-up visit?)

  • Members that have more than a 30-day supply of opioids in a single year

  • Members that have more than a 14-day supply of opioids from two or more prescribing physicians

And that’s just the start. Data and analytics reveal the identify the prevalence of any opioid issues within a member population, trends in prescribing, the cost (often increased) of members with opioid issues and more.

“The power of analytics when reviewing opioid addiction is that the analyses normally uncovers other areas of concern for the employee/dependent – things like depressions, accidents at work, frequently of prescription fills that are abnormal and more,” Will Herold, DHS Group VP of Business Development, said. “These are areas that employers can then create programs or strategies without having to address the potential problem with opioids directly with the employee.”

The use of data and analytics is a first step towards ACTION. With the right information behind you, the proper course of action towards better population health and lower benefits costs – from education, counseling and rehab programs to wellness programs, health coaching and on-site clinics – is one step closer.


Interested in the technology behind identify potential opioid misuse in your population or how data and analytics can help your population health? Fill out this quick form and someone will be in touch shortly.