Pregnant women with opioid use disorder who were prescribed buprenorphine had fewer emergency department visits and hospital admissions, with the greatest benefit seen among those who adhered to treatment on at least 80% of days.
RT’s Three Key Takeaways:
- High Costs for Pregnant Patients with OUD: A study in Anesthesiology found that pregnant women with opioid use disorder incurred about $33,000 in health care costs in the year before delivery, far exceeding typical costs for other chronic conditions.
- Buprenorphine Lowers ED Visits and Hospitalizations: Patients prescribed buprenorphine had fewer emergency department visits and hospital admissions, with the greatest benefit seen among those who adhered to treatment on at least 80% of days.
- Integrating Addiction Treatment into Prenatal Care: Researchers emphasize that expanding access to and adherence with buprenorphine during pregnancy could improve maternal health outcomes and significantly reduce health care expenditures.
Pregnant women with opioid use disorder (OUD) account for $33,000 per year in healthcare costs in the year before delivery, according to new research in Anesthesiology.
Among patients who were prescribed buprenorphine for OUD, the study found that better adherence to their treatment regimen was associated with lower costs. Moreover, for pregnant women with OUD, medications for OUD including buprenorphine, may reduce the need for emergency department (ED) visits.
“Patients who follow their prescribed treatment more closely have reductions in hospital admissions and total health care costs,” said Eric C. Sun, M.D., Ph.D., co-author of the study and associate professor of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine, California. “Increasing access and adherence to buprenorphine may reduce high-cost, acute-care use during pregnancy.”
Treatment with evidence-based medications like buprenorphine is an important strategy for managing OUD during pregnancy. Using buprenorphine or other medications to reduce cravings and withdrawal symptoms has been shown to improve health outcomes – including a reduced risk of overdose – for patients with OUD.
The study included data on 4,661 pregnant patients with OUD who delivered between 2007 and 2023, drawn from a commercial insurance database. In the year before delivery, 40% of patients filled a prescription for buprenorphine.
Overall, pregnant patients with OUD had high health care costs in the year before delivery: about $33,000 (excluding costs related to the delivery itself). That was substantially higher than the annual health care cost for patients with diabetes, and comparable to that for patients with heart failure.
However, for patients taking buprenorphine, the rate of ER visits was significantly lower, with an average of 1.81 visits, compared to 2.35 in patients who did not take buprenorphine. On comparison of different patient subgroups, the decrease in ER visits was significant, mainly for patients who made more frequent prenatal care visits (at least 10 visits).
For patients who were prescribed buprenorphine, those who took buprenorphine more regularly, i.e., on at least 80% of possible days, experienced significantly lower health care costs and fewer hospital admissions, in addition to reduced ER visits, compared to those who did not.
“Our findings provide some support for current clinical guidelines by showing that treatment with buprenorphine may reduce the need for costly ER visits for pregnant patients with OUD,” said Dr. Sun. “Increased efforts to integrate addiction treatment into prenatal care may lead to better clinical outcomes while reducing health care costs.”
