High cost of substance use disorder can be offset by employer sponsored insurance
The estimated annual medical cost of SUDs in the non–Medicare eligible U.S. employer-sponsored insurance (ESI) population was $15,640 per affected enrollee.
Depression, anxiety, loneliness and pandemic isolation, at the extreme, can have the unfortunate effects of increasing substance use disorder (SUD) in the U.S. In fact, direct costs of SUDs are incurred primarily among the working-age population. In order to understand and improve the medical costs this incurs, plan sponsors will need the information on how it affects the workplace and how to best make decisions on the value of prevention strategies.
A new study authored by Dr. Cora Peterson and Dr. Mengyao Li at the Centers for Disease control, says that in 2018, 2.3 million people had an SUD diagnosis. The annual attributable medical expenditure was $15,640 per affected enrollee and $35.3 billion in the population; alcohol-related disorders ($10.2 billion) and opioid-related disorders ($7.3 billion) were the most costly.
At the employer level, these findings show that employers and health insurance payers can influence, and support, employees and dependents to prevent SUDs. They can also consider prevention strategies in terms of potentially offsetting the existing high medical cost of SUDs.
The trends are not good. According to the report, during 2001 to 2020, more than 90% of deaths (865,732 of 932,573) caused by drug or alcohol poisoning and nearly 80% of nonfatal poisoning emergency department visits (20.1 million of 25.7 million) occurred among people aged 20 to 64 years. Overall, 11% of U.S.-employed adults (aged 18 years or older) reported having SUDs in 2020. More than half of employers with 50 or more employees surveyed in 2019 reported direct effects from the opioid overdose epidemic, such as impaired or decreased job performance.
Related: Adding SUD coverage could offset Medicare costs, says study
The authors of the report found that the estimated annual medical cost of SUDs in the non–Medicare eligible U.S. employer-sponsored insurance (ESI) population was $15,640 per affected enrollee and $35.3 billion in total during 2018. The cost of strategies to support employees and their health insurance dependents to prevent and treat SUDs can be considered in terms of potentially offsetting the existing high medical cost of SUDs. Medical expenditures for SUDs represent the minimum direct cost that employers and health insurers face because not all people with SUDs have a diagnosis, and costs related to absenteeism, presenteeism, job retention, and mortality are not addressed.