Friday, December 22, 2017

Prescription oxycodone with American flag in background

A pervasive and dangerous myth surrounding the opioid epidemic is that its scope is limited to specific populations, and, for the rest of the country, crisis-level has not yet been reached. I’m far removed from the epicenter of the epidemic—both socio-demographically and geographically—and on one level, can understand that thinking. But at the same time, I don’t have to go very deep into my list of acquaintances to find people I personally know whose lives have been damaged by opioid addiction. Despite coordinated efforts to ebb the crisis, it has steadily grown, and in the absence of a solution, it will continue to devastate our country, claiming the lives of about one hundred Americans daily.

Drug overdoses have become the leading cause of death for those under 50 in the United States. If viewing this national emergency through the lens of humanitarianism alone isn’t motivation enough to throw everything we have into addressing it, perhaps looking at the economics of it will be. To inform the business case, my colleagues in Altarum’s newly founded Center for Value in Health Care recently estimated the 2016 economic cost of overdoses, deaths, and addiction at about $95 billion dollars. To conduct their analysis the team relied on our Value of Health tool. In its current form, the tool’s flexibility allows inputs across a variety of metrics, e.g. productivity, health spending, and criminal justice costs, to produce economic outcomes that are relevant to a variety of stakeholders.

If viewing this national emergency through the lens of humanitarianism alone isn’t motivation enough to throw everything we have into addressing it, perhaps looking at the economics of it will be.

Perhaps 95 billion dollars over the course of an entire year doesn’t sound like that much. To put it into perspective it’s $25 billion more than the entire federal education budget for the same time period, and $15 billion more than was allocated to the Department of Health and Human Services. The scary thing is that if anything, this is a rather conservative estimate of the cost of the opioid epidemic. If the status quo continues, within the next decade we’ll easily reach the trillion dollar mark of cumulative costs. Our current estimate also does not adequately capture the downstream impact of parents’ opioid addiction on their children. With an unprecedented influx of children whose parents are addicts entering the foster care system and babies in opiate withdrawal now being born every 25 minutes in this country, opioid misuse is truly an intergenerational health epidemic. To better inform the ripple effects of this type of public health crisis, we’re working on a redesign of the Value of Health tool and will expand its capabilities to include not only the costs of those currently struggling with substance misuse but also the compounded and amplified effects it will have on their children’s life course trajectory.

Focusing on the cost of the epidemic, either in terms of economics or the implicitly valuable human lives that are lost or irrevocably damaged, draws attention; it can also inadvertently promote a sense of helplessness. As we convince those who hold the purse strings to invest resources to address this epidemic, we also must offer them viable evidence-based solutions. That’s why the Value of Health tool redesign will model the impact of policies and programs aimed at preventing addiction, and those aimed at remediating impact—as much as is possible—once an individual has already become addicted to opioids. Iterations of the tool currently underway will expand its capabilities to compare the efficacy of different interventions as well as combine interventions that hold the most promise.

As we convince those who hold the purse strings to invest resources to address this epidemic, we also must offer them viable evidence-based solutions.

I fear that we’ve become a nation of complainers, jumping at the chance to point out inequities and injustices without actually trying to fix them. My colleagues and I are committed to producing action-oriented insights and the Value of Health tool is only one example of that commitment. We hope you will join us on our mission so that, together, we can remove the barriers to better health and health care for all.


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