Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs
Cytochrome P450 2D6 (CYP2D6) activity is highly variable due to several factors, including genetic polymorphisms and drug-drug-gene interactions. Hydrocodone, oxycodone, codeine, and tramadol the most commonly prescribed CYP2D6-activated opioids for pain. However, the co-administration of CYP2D6 int...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-11-01
|
| Series: | Journal of Personalized Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4426/11/11/1174 |
| _version_ | 1797509726800445440 |
|---|---|
| author | Veronique Michaud Ravil Bikmetov Matt K. Smith Pamela Dow Lucy I. Darakjian Malavika Deodhar Brian Cicali Kevin T. Bain Jacques Turgeon |
| author_facet | Veronique Michaud Ravil Bikmetov Matt K. Smith Pamela Dow Lucy I. Darakjian Malavika Deodhar Brian Cicali Kevin T. Bain Jacques Turgeon |
| author_sort | Veronique Michaud |
| collection | DOAJ |
| description | Cytochrome P450 2D6 (CYP2D6) activity is highly variable due to several factors, including genetic polymorphisms and drug-drug-gene interactions. Hydrocodone, oxycodone, codeine, and tramadol the most commonly prescribed CYP2D6-activated opioids for pain. However, the co-administration of CYP2D6 interacting drugs can modulate CYP2D6-medicated activation of these opioids, affecting drug analgesia, effectiveness, and safety, and can impact healthcare costs. A retrospective, observational cohort analysis was performed in a large (<i>n</i> = 50,843) adult population. This study used drug claims data to derive medication risk scores and matching propensity scores to estimate the effects of opioid use and drug-drug interactions (DDIs) on medical expenditures. 4088 individuals were identified as opioid users; 95% of those were prescribed CYP2D6-activated opioids. Among those, 15% were identified as being at risk for DDIs. Opioid users had a significant increase in yearly medical expenditure compared to non-opioid users ($2457 vs. $1210). In matched individuals, average healthcare expenditures were higher for opioid users with DDIs compared to those without DDIs ($7841 vs. $5625). The derived medication risk score was higher in CYP2D6 opioid users with interacting drug(s) compared to no DDI (15 vs. 12). Higher costs associated with CYP2D6 opioid use under DDI conditions suggest inadequate CYP2D6 opioid prescribing practices. Efforts to improve chronic opioid use in adults should reduce interacting drug combinations, especially among patients using CYP2D6 activated opioids. |
| first_indexed | 2024-03-10T05:21:52Z |
| format | Article |
| id | doaj.art-8a0b01b0648b4a809d299f946406bc5c |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T05:21:52Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-8a0b01b0648b4a809d299f946406bc5c2023-11-22T23:59:01ZengMDPI AGJournal of Personalized Medicine2075-44262021-11-011111117410.3390/jpm11111174Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare CostsVeronique Michaud0Ravil Bikmetov1Matt K. Smith2Pamela Dow3Lucy I. Darakjian4Malavika Deodhar5Brian Cicali6Kevin T. Bain7Jacques Turgeon8Tabula Rasa HealthCare (TRHC), Precision Pharmacotherapy Research and Development Institute, Orlando, FL 32827, USATabula Rasa HealthCare (TRHC), Precision Pharmacotherapy Research and Development Institute, Orlando, FL 32827, USATabula Rasa HealthCare (TRHC), Precision Pharmacotherapy Research and Development Institute, Orlando, FL 32827, USATabula Rasa HealthCare (TRHC), Precision Pharmacotherapy Research and Development Institute, Orlando, FL 32827, USATabula Rasa HealthCare (TRHC), Precision Pharmacotherapy Research and Development Institute, Orlando, FL 32827, USATabula Rasa HealthCare (TRHC), Precision Pharmacotherapy Research and Development Institute, Orlando, FL 32827, USACenter for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32611, USABiophilia Partners, Philadelphia, PA 19103, USATabula Rasa HealthCare (TRHC), Precision Pharmacotherapy Research and Development Institute, Orlando, FL 32827, USACytochrome P450 2D6 (CYP2D6) activity is highly variable due to several factors, including genetic polymorphisms and drug-drug-gene interactions. Hydrocodone, oxycodone, codeine, and tramadol the most commonly prescribed CYP2D6-activated opioids for pain. However, the co-administration of CYP2D6 interacting drugs can modulate CYP2D6-medicated activation of these opioids, affecting drug analgesia, effectiveness, and safety, and can impact healthcare costs. A retrospective, observational cohort analysis was performed in a large (<i>n</i> = 50,843) adult population. This study used drug claims data to derive medication risk scores and matching propensity scores to estimate the effects of opioid use and drug-drug interactions (DDIs) on medical expenditures. 4088 individuals were identified as opioid users; 95% of those were prescribed CYP2D6-activated opioids. Among those, 15% were identified as being at risk for DDIs. Opioid users had a significant increase in yearly medical expenditure compared to non-opioid users ($2457 vs. $1210). In matched individuals, average healthcare expenditures were higher for opioid users with DDIs compared to those without DDIs ($7841 vs. $5625). The derived medication risk score was higher in CYP2D6 opioid users with interacting drug(s) compared to no DDI (15 vs. 12). Higher costs associated with CYP2D6 opioid use under DDI conditions suggest inadequate CYP2D6 opioid prescribing practices. Efforts to improve chronic opioid use in adults should reduce interacting drug combinations, especially among patients using CYP2D6 activated opioids.https://www.mdpi.com/2075-4426/11/11/1174CYP2D6drug-drug interactionsopioidsmedical expenditurepharmacoeconomicsmedication risk score |
| spellingShingle | Veronique Michaud Ravil Bikmetov Matt K. Smith Pamela Dow Lucy I. Darakjian Malavika Deodhar Brian Cicali Kevin T. Bain Jacques Turgeon Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs Journal of Personalized Medicine CYP2D6 drug-drug interactions opioids medical expenditure pharmacoeconomics medication risk score |
| title | Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs |
| title_full | Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs |
| title_fullStr | Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs |
| title_full_unstemmed | Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs |
| title_short | Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs |
| title_sort | use of drug claims data and a medication risk score to assess the impact of cyp2d6 drug interactions among opioid users on healthcare costs |
| topic | CYP2D6 drug-drug interactions opioids medical expenditure pharmacoeconomics medication risk score |
| url | https://www.mdpi.com/2075-4426/11/11/1174 |
| work_keys_str_mv | AT veroniquemichaud useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT ravilbikmetov useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT mattksmith useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT pameladow useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT lucyidarakjian useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT malavikadeodhar useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT briancicali useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT kevintbain useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts AT jacquesturgeon useofdrugclaimsdataandamedicationriskscoretoassesstheimpactofcyp2d6druginteractionsamongopioidusersonhealthcarecosts |