Gender differences among patients receiving pain therapy — United States, 2009–2014

Background: In 2013, CDC called attention to the dramatic rise in prescription opioid pain reliever (OPR) overdose deaths among women. The most recent mortality data available (2013) indicate a decline among men in OPR-related deaths but a rise among women. 

Methods:  Monthly data on patient utilization comes from the IMS Health Total Patient Tracker and National Prescription Audit (NPA) for January 2009-May 2014. The system provides unique total patient counts and is designed to count projected total patients on a therapy.  Analyses include patient estimates and rates for opioid formulations (extended release/long acting (ER/LA; e.g., OxyContin, Opana ER) versus immediate release (IR; e.g., hydrocodone/APAP, tramadol)) and NSAIDs for comparison.

Results: Over 9.6 million female and 6.9 million male patients were receiving IR opioid pain relievers in May 2014.  Between January 2009 and May 2014, patient rates increased for females and males for opioid formulations (IR F: 22%; M: 21%; ER/LA F: 8%; M: 5%) while NSAIDs rates declined for females (-8.4%) and increased for males (8.4%). The F:M rate ratio was >1 in every month for IR, ER/LA, and NSAIDs.  Results also describe individual drug trends.

Conclusions: The number of patients receiving opioid analgesics continued to rise into 2014. Understanding changes in patients on specific therapies in near real-time captures shifts in use of specific drugs which can be valuable for targeting overdose prevention measures. Public health interventions to reduce overdoses must strike a balance between reducing misuse and safeguarding legitimate access to treatment.