Spending trends on substance abuse treatment under private employer-sponsored insurance, 2001-2009.

BACKGROUND: From 1986 to 2003, substance abuse spending covered by private insurance fell in nominal dollars from $2444 million to $2239 million. The present study updated this literature to determine recent spending and utilization trends and provides a baseline for assessing the effects of recent health care policy changes.

METHODS: We used insurance claims data from Thomson Reuters MarketScan Commercial Claims and Encounters Database to study approximately 100 large, self-insured employers and millions of enrollees. We examined patterns in substance abuse treatment utilization and spending from 2001 through 2009.

RESULTS: The study revealed that substance abuse spending remained a relatively constant share of all health spending, comprising about 0.4% of all health spending in 2009. The share of substance abuse spending on medications increased from 1% to 14%, but remained a small share of all health spending at about $2.45 per-member per-year.

CONCLUSIONS: The study has implications for anticipating the effects of the federal parity law, in that the low share of substance abuse treatment means that even large increases in substance abuse utilization and spending are unlikely to have a significant impact on total health care costs.