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...

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Autores principales:	Veronique Michaud, Ravil Bikmetov, Matt K. Smith, Pamela Dow, Lucy I. Darakjian, Malavika Deodhar, Brian Cicali, Kevin T. Bain, Jacques Turgeon
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	CYP2D6 drug-drug interactions opioids medical expenditure pharmacoeconomics medication risk score Medicine R
Acceso en línea:	https://doaj.org/article/8a0b01b0648b4a809d299f946406bc5c
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spelling	oai:doaj.org-article:8a0b01b0648b4a809d299f946406bc5c2021-11-25T18:07:47ZUse of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs10.3390/jpm111111742075-4426https://doaj.org/article/8a0b01b0648b4a809d299f946406bc5c2021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1174https://doaj.org/toc/2075-4426Cytochrome 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.Veronique MichaudRavil BikmetovMatt K. SmithPamela DowLucy I. DarakjianMalavika DeodharBrian CicaliKevin T. BainJacques TurgeonMDPI AGarticleCYP2D6drug-drug interactionsopioidsmedical expenditurepharmacoeconomicsmedication risk scoreMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1174, p 1174 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	CYP2D6 drug-drug interactions opioids medical expenditure pharmacoeconomics medication risk score Medicine R
spellingShingle	CYP2D6 drug-drug interactions opioids medical expenditure pharmacoeconomics medication risk score Medicine R 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
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.
format	article
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
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_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_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_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
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8a0b01b0648b4a809d299f946406bc5c
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Use of Drug Claims Data and a Medication Risk Score to Assess the Impact of CYP2D6 Drug Interactions among Opioid Users on Healthcare Costs

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