The cost in human terms is incalculable, but that doesn't mean that the monetary expense involved in the opioid epidemic was small.

In fact, according to a Society of Actuaries' (SOA) analysis of non-medical opioid use from 2015 to 2018, the opioid epidemic cost the U.S. economy at least $631 billion—and is likely to continue to do so in the future.

The report, written by Milliman, also projected the epidemic's future costs for 2019; the analysis based its numbers on three scenarios that project how the crisis will continue to develop. Its conclusion estimates that at the low end the cost will be $172 billion, the midpoint $188 billion and the high end $214 billion.

The study is the first in the SOA's Mortality and Longevity Strategic Research Program, which analyzes mortality trends as well as examining the factors affecting models and mortality predictions. The study found that the crisis played out across the following sectors of the U.S. economy during the study period: health care (accounting for some $205 billion); premature mortality ($253 billion); criminal justice activities ($39 billion); child and family assistance and education programs ($39 billion); and lost productivity ($96 billion).

The projected future cost estimates are based on assumptions including prevalence of opioid use disorder and the number of opioid overdose deaths in 2019. Data sources include administrative claims data, federal surveys and databases, as well as prior peer-reviewed literature to determine the total economic burden.

The analysis does not include, says the report, economic impacts that lack adequate data, such as reductions in household (nonpaid) productivity, reductions in on-the-job productivity (presenteeism) or reductions in quality of life for those impacted directly or indirectly by opioid use disorder.

"As stakeholders seek to understand and address the opioid epidemic, this analysis provides insight into the tremendous impact across all areas of our economy," says Dale Hall, FSA, CERA, MAAA, CFA and managing director of research with the Society of Actuaries. "Actuaries have long played a vital role in measuring population-level risks, and will continue to work with the healthcare industry to evaluate the impact of the opioid epidemic on pricing, valuation and other crucial calculations moving forward."

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Instant Insights /

Opioid epidemic cost U.S. $631 billion over the past 4 years

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