Rising opioid prescription fulfillment among non-cancer and non-elderly patients—Israel’s alarming example

Miron, Oren; Zeltzer, Dan; Shir, Tzvi; Balicer, Ran D.; Einav, Liran; Feldman, Becca

doi:10.1136/rapm-2020-101924

Cited by 22 publications

(24 citation statements)

References 3 publications

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“…[16,17] The relatively low rate is also unexpected considering recent police reports of widespread opioid abuse in Israel, and the recent finding of increased opioid consumption within CHS. [10,18]. Similar difficulties in identifying opioid use disorder and probable under-reporting has been shown in other countries as well.…”

Section: Discussionsupporting

confidence: 56%

“…The Israeli increase in opioid consumption occurred mainly with Oxycodone and Fentanyl, which are highly addictive,[9] and are predominantly prescribed to non-elderly patients who do not suffer from malignancy, characteristics that have been found to increase the risk of developing opioid abuse. [10] There have been specific reports of increasing opioid use disorder in Israel, the United Kingdom, and other countries with public healthcare systems; yet, the health care burden of opioid abuse in these countries has been studied to a lesser extent than in the US. [11,12]…”

Section: Introductionmentioning

confidence: 99%

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Association of opioid use disorder with healthcare utilization and cost in a public health system

Miron

Barda

Balicer

et al. 2021

Preprint

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Background and objectives: To quantify the healthcare costs associated with opioid use disorder among members in a public healthcare system, and compare them to healthcare costs in the general population. Methods: Retrospective cohort study in inpatient and outpatient care settings of Israel's largest public healthcare provider (that covers 4.7 million members). Participants included 1,173 members who had a diagnosis of opioid use disorder in the years between 2013 and 2018. Each patient was matched with 10 controls based on age and sex. The main outcome was monthly healthcare costs. Results: The mean monthly healthcare cost of members with opioid use disorder was $1,102 compared to $211 among controls (5.2-fold difference; 95% confidence interval [CI]: 4.6-6.0). After excluding members with heroin related diagnoses before the index date (in order to focus on prescription opioids), this healthcare cost ratio did not substantially change (4.6-fold; 95%-CI: 3.9-5.4). Members with opioid use disorder under the age of 65 years had a cost difference of 6.1-fold (95%-CI: 5.2-7.1), while those 65 years and older experienced cost difference of 3.4-fold (95%-CI: 2.6-4.5). The category with the highest cost for members with opioid use disorder was inpatient services, which was 8.7-fold (95%-CI 7.2-10.4) greater than among controls. Conclusions: Healthcare costs among individuals with opioid use disorder in a public health system were substantially higher than among controls, at least partially attributed to prescription opioid use disorder. Differences were greater among individuals younger than 65 years, highlighting the importance of preventing and treating opioid use disorder among younger adult populations.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Association of opioid use disorder with healthcare utilization and cost in a public health system

Miron

Barda

Balicer

et al. 2021

Preprint

Self Cite

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“…Clalit Health Services (CHS) is the largest Health Provider Organisation in Israel, with a membership of 4.5 million, about 52% of the country population 12. CHS operates 14 medical centres.…”

Section: Methodsmentioning

confidence: 99%

BNT162b2 mRNA COVID-19 vaccine and booster in patients with autoimmune rheumatic diseases: a national cohort study

et al. 2022

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IntroductionEmerging evidence supports the immunogenic response to mRNA COVID-19 vaccine in patients with autoimmune rheumatic diseases (ARD). However, large-scale data about the association between vaccination, and COVID-19 outcomes in patients with ARD is limited.MethodsWe used data from Clalit Health Services, which covers more than half of the population in Israel. Patients with ARD older than 18 were included between 20 December 2021 and 30 September 2021, when the BNT162b2 mRNA COVID-19 vaccine, and later a third booster dose, were available. The primary outcome was a documented positive SARS-CoV-2 PCR test. We used a Cox regression models with vaccination status as time-dependent covariate and calculated the HR for the study outcome.ResultsWe included 127 928 patients with ARD, of whom, by the end of the study follow-up, there were 27 350 (21.3%) unvaccinated patients, 31 407 (24.5%) vaccinated patients and 69 171 (54.1%) patients who also received a third booster-dose. We identified 8470 (6.6%) patients with a positive SARS-CoV-2 PCR test during the study period. The HR for SARS-CoV-2 infection among the vaccination group was 0.143 (0.095 to 0.214, p<0.001), and among the booster group was 0.017 (0.009 to 0.035, p<0.001). Similar results were found regardless of the type of ARD group or antirheumatic therapy.ConclusionOur results indicate that both the BNT162b2 mRNA COVID-19 vaccine and the booster are associated with better COVID-19 outcomes in patients with ARD.

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“…We extracted data from Clalit Health Services (CHS), the largest Health Provider Organization in Israel, operating mandatory health insurance, covering over half of the country's population. [8] CHS has a centralized, comprehensive computerized database of electronic healthcare records that has received continuous real-time input from the medical, laboratory, pharmaceutical, vaccination, and hospitalization operating systems, since the beginning of the 2000s. Hence, the CHS dataset represents Israel's general population in Israel and has been previously shown to have provided highly valid and reliable estimates.…”

Section: Methodsmentioning

confidence: 99%

SARS-CoV-2 infection among patients with autoimmune rheumatic diseases; comparison between the Delta and Omicron waves in Israel

Bieber¹,

Brikman²,

Novack³

et al. 2023

Seminars in Arthritis and Rheumatism

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Rising opioid prescription fulfillment among non-cancer and non-elderly patients—Israel’s alarming example

Cited by 22 publications

References 3 publications

Association of opioid use disorder with healthcare utilization and cost in a public health system

Association of opioid use disorder with healthcare utilization and cost in a public health system

BNT162b2 mRNA COVID-19 vaccine and booster in patients with autoimmune rheumatic diseases: a national cohort study

SARS-CoV-2 infection among patients with autoimmune rheumatic diseases; comparison between the Delta and Omicron waves in Israel

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