Economic impact of potential drug–drug interactions in opioid analgesics

Abstract

Since concurrent exposure to DDEs with the potential to cause PK DDIs may be relatively common, policy decisions-makers should consider the use of long-acting opioids that are not metabolized through the CYP450 pathway.

The Prevalence of Opioid-Related Major Potential Drug-Drug Interactions and Their Impact on Health Care Costs in Chronic Pain Patients

“…16,17 In patients with osteoarthritis taking a CYP450 metabolized opioid, the risk of exposure to a potentially interacting drug was higher in females and increased with age and the number of medications at baseline before receiving an opioid. 18 These data are in agreement with our current results and suggest that many chronic users of opioids are at high risk for potential pDDIs.…”

“…It has been conservatively estimated that approximately 27% of chronic opioid users are exposed to pDDIs. 18 For a majority of patients, this type of drug-drug exposure will not result in a pDDI-Major, as the prevalence of such exposures from our study was about 5.7%. While the prevalence of pDDI-Major may seem small (1 in 18), these patients required substantially more resources than pDDI-None patients.…”

“…16,17 Among patients using opioids, regardless of diagnosis, the mean 6-month health care costs after pDDIs were significantly higher versus matched patients without pDDIs (difference of $667). 18 Thus, pDDIs seem to lead to side effects that incur increased health care costs. The high prevalence of pDDIs suggests that opioid product selection should include considerations of CYP450 metabolism, but the relatively high prevalence of these interactions may hinder utilization management efforts.…”

“…19 Some studies have been published on the topic of CYP450 related pDDIs between opioids and precipitant drugs. [16][17][18][19][20][21] However, one major limitation associated with these studies was that the pDDI was simply defined as a concurrent exposure between an opioid metabolized through the CYP450 system and a precipitant drug (inducer or inhibitor), which was also metabolized through the CYP450 system.…”

Drug-Drug Interaction Associated with Mold-Active Triazoles among Hospitalized Patients

“…DDIs are associated with significant clinical consequences and higher resource use and costs (7,8). DDIs are common among patients taking multiple medications, with the prevalence estimated to range from 60.0% to 70.3% among hospitalized patients, and are associated with increased lengths of stay, higher rates of morbidity and mortality, and higher health care costs (7)(8)(9)(10)(11)(12)(13)(14). The risk of DDIs among mold-active triazoles has been an important factor contributing to the recommendation of consistent therapeutic drug monitoring of mold-active triazoles in the guidelines from the Infectious Diseases Society of America.…”