TABLE 2.
Estimated Costs of Opioid Use Disorder and Fatal Overdose, United States 2017 (Millions of 2017$)
| Nonfatal Costs | Aggregate Costs (95% Prediction Interval) | Percentage of Aggregate Costs |
|---|---|---|
| Health Care | ||
| Private Insurance | $12,902 | 1.3% |
| Medicare | $3,170 | 0.3% |
| Medicaid | $11,142 | 1.1% |
| Champus/VA | $1,124 | 0.1% |
| Other | $820 | 0.1% |
| Uninsured | $2,151 | 0.2% |
| Total | $31,308 | 3.1% |
| ($25,171, $37,444) | ||
| Substance Abuse Treatment | ||
| Federal | $844 | 0.1% |
| State and Local | $2,326 | 0.2% |
| Private | $365 | 0.0% |
| Total | $3,534 | 0.3% |
| ($3,355, $3,714) | ||
| Criminal Justice | ||
| Police protection | $6,209 | 0.6% |
| Legal and adjudication | $2,819 | 0.3% |
| Correctional facilities | $5,445 | 0.5% |
| Property lost due to crime | $347 | 0.0% |
| Total criminal justice costs | $14,819 | 1.5% |
| ($14,181, $15,462) | ||
| Lost Productivity | ||
| Reduced productive time/increased disability | $23,479 | 2.3% |
| Production lost for incarcerated individuals | $7,832 | 0.8% |
| Total Lost Productivity | $31,311 | 3.1% |
| ($26,681, $35,954) | ||
| Value of Reduced Quality of Life | $390,003 | 38.2% |
| ($337,693, $444,278) | ||
| Total Non Fatal Costs | $470,975 | 46.1% |
| ($417,783, $525,692) | ||
| Fatal Costs | ||
| Lost Productivity | $68,694 | 6.7% |
| Health Care | $260 | 0.0% |
| Value of Statistical Life Lost | $480,737 | 47.1% |
| Total Fatal Costs | $549,691 | 53.9% |
| ($544,835, $554,546) | ||
| Total of Nonfatal and Fatal | $1,020,666 | 100.0% |
| ($967,244, $1,075,680) | ||
Source: Author’s calculations using the National Survey of Drug Use and Health, the National Vital Statistics System mortality data; Opioid Overdose deaths identified based on International Classification of Diseases, Tenth Revision codes for drug overdoses: X40-X44, X60-X64, X85, and Y10-Y14; the type of drug involved was based on ICD-10 codes for opioids (all T40.0-T40.4 and T40.6), IBM MarketScan® Research Databases (Health Care Costs); Substance Abuse and Mental Health Services Administration. Projections of National Expenditures for Treatment of Mental and Substance Use Disorders, 2010–2020. (Use Disorder Treatment Costs), Bureau of Justice Statistics. Justice Expenditure and Employment Extracts, 2015 – Preliminary., United States Department of Justice, Federal Bureau of Investigation. Crime in the United States 2015., Office of National Drug Control Policy. The economic costs of drug abuse in the United States: 1992–2002., Drug Enforcement Administration. National Forensic Laboratory Information System: 2012 Annual Report., Carson EA. Prisoners in 2016. Bureau of Justice Statistics 2018, (Reduced Quality of Life) Wittenberg, E., Bray, J.W., Aden, B., Gebremariam, A., Nosyk, B., Schackman, B.R., 2016. Measuring benefits of opioid misuse treatment for economic evaluation: health-related quality of life of opioid-dependent individuals and their spouses as assessed by a sample of the US population. Addiction 111(4), 675–684., (Lost productivity: non-fatal) Krueger, K.V.G., Scott D. Pike, Jamison, 2018. Estimated annual and lifetime labor productivity in the United States, 2016: implications for economic evaluations Journal of Medical Economics, 1–8. (Value of statistical life and year) Office of the Assistant Secretary for Planning and Evaluation. Guidelines for regulatory impact analysis. Washington, DC: U.S. Department of Health and Human Services; 2016 and the (Health care costs and lost productivity: fatal) Web-based injury statistics query and reporting system (WISQARS). Prediction intervals are based on probabilistic simulations.