Research has demonstrated increased annual medical costs in patients who abuse opioids, estimated at up to $18,000 per patient and $29 billion overall in the US. Our aim was to evaluate the financial impact of any pre-transplant opioid use on readmission costs in kidney transplants.

Methods:

Retrospective, single center analysis evaluating kidney transplants between 1/2010 and 12/2016. Opioid use was defined as an opioid reported during medication reconciliation at the time of transplant or opioid prescription within 3 months from a national pharmacy claims database. Costs were adjusted to 2016 values utilizing a 3% average inflation rate per year.

Results:

Out of 1,129 kidney transplants, 271 (24%) were opioid experienced (OE) and 858 (76%) were opioid naïve (ON). Patients that were OE were more likely to be white, more highly sensitized, and had more baseline benzodiazepine use (Table 1). There were no differences between cohorts in LOS, cost of transplant hospitalization, or rejection rates. The number of readmissions for patients in each cohort can be visualized in Figure 1. OE patients demonstrated significantly more readmissions and a significantly higher mean total cost of readmissions at 30-, 90-, and 365-days after transplant (Table 2).

Conclusion:

Pre-transplant opioid use is significantly associated with increased costs associated with readmissions in the year after kidney transplantation. Causes and preventability of readmissions should be further explored.

CITATION INFORMATION: Wilson L., Taber D., Pilch N., Gilbert R., Elmaasarani Z., O'Brien B., Patel N., Mauldin P., Ball S., Baliga P., Fleming J. The Financial Impact of the Opioid Epidemic on Kidney Transplantation Readmissions Am J Transplant. 2017;17 (suppl 3).

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