Author
Brett J Skinner, Ph.D.
Introduction
Available evidence suggests non-medical use (NMU) of prescription opioids (RxO) in Canada is significant, and is partly facilitated by users who modify the drug product. Abuse deterrent formulations (ADF) exist but are not mandatory for all prescription opioids.
Objective
This study estimates the magnitude of the societal economic costs in Canada resulting from non-medical use of prescription opioids that could be avoided if all prescription opioids were mandated to be abuse deterrent formulations and were as effective as existing technology.
Data and Method
This paper builds on the methods and the data sources used in a 2012 study on the same topic: “Skinner BJ (2012). Net societal economic impact in Canada from withholding regulatory approval for generic OxyContin®. Canadian Health Policy, September 12, 2012. Toronto: Canadian Health Policy Institute.” A literature review was conducted to update and summarize the state of evidence regarding the effectiveness of tamper resistant/abuse deterrent formulations for opioid products. A scan of related policy developments was conducted. New data and evidence were used to update from previous estimates of societal economic costs. Utilization data were obtained from QuintilesIMS.
Results
Estimated total societal economic costs from non-medical use of prescription opioids in Canada averaged about $4.3 billion per year. The four-year cumulative total was $17.1 billion from 2012 to 2015. The literature reviewed for this study found that existing ADF technologies were effective at reducing NMU rates. Estimates ranged from 3.3% to 98.8% effective at reducing the NMU rate. The median ADF effectiveness reducing NMU rates by between 45.1% and 64%. The range of the costs that could potentially have been avoided if ADF had been mandatory for all prescription opioids in Canada is determined by the effectiveness factored into each calculation. The four-year cumulative total from 2012 to 2015 ranged from $560 million to $16.9 billion (averaging from $140 million to $4.2 billion per year). The median estimate is about $9.3 billion for the entire period (averaging $2.3 billion per year).
Conclusions
The data suggest that the expected reduction in the NMU rate for RxO that would result from mandating adoption of existing ADF technology across all opioids, would very likely produce significant net societal cost savings.
