Opioid-induced constipation (OIC) may significantly increase economic burden and healthcare resource use among patients with cancer-associated pain, according to a study published in Supportive Care in Cancer.

Among the most commonly used treatments for cancer pain — a common and debilitating symptom shown in studies to occur in more than 50% of patients — are opioid analgesics. Although opioid therapy is effective for pain management, treatment is highly associated with OIC and may lead to significant reductions in quality of life. 

For this study, researchers retrospectively assessed the outcomes of 2738 patients with cancer pain. Eligible patients must have had a claim for opioid use and used continuous opioid therapy for at least 30 days. Researchers sought to evaluate healthcare use and costs among patients with (cohort 1) and without constipation (cohort 2) during the first year of treatment with opioids. 

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Results showed that patients who experienced OIC had a 2-fold increase in risk of all-cause inpatient hospitalization (odds ratio [OR], 2.47) or pain-related hospitalization (OR, 2.15) during the first year of initiating therapy compared with patients who did not develop OIC. 

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The mean unadjusted overall healthcare costs for patients with constipation in the first year were $21,626 higher compared with those without constipation. The total mean constipation-related costs were nearly $10,000. 

The authors concluded that “the increase in resource utilization in patients with constipation suggests that there may be a need for early and ongoing management of constipation among patients with cancer-related pain receiving opioid analgesics in order to reduce the burden and increased costs associated with constipation in this setting.”


Fine PG, Chen YW, Wittbrodt E, Datto C. Impact of opioid-induced constipation on healthcare resource utilization and costs for cancer pain patients receiving continuous opioid therapy[published online July 29, 2018]. Support Care Cancer. doi: 10.1007/s00520-018-4366-z