Economic Burden of Infant Drug Exposure in Texas

Matthew G Myers, The University of Texas School of Public Health


In congruence with the “opioid epidemic”, rates of infants born exposed to drugs in utero are steadily climbing . These infants have adverse and costly pregnancy outcomes. Understanding the prevalence and economic expenditure trends associated with infant drug exposure are essential for effective implementation of public health responses. This analysis aims to be a comprehensive estimate of the economic burden due to infant drug exposure and Neonatal Abstinence Syndrome (NAS) in Texas and nationwide. A retrospective incidence based cost-of-illness study was utilized to determine the cost-to-charge/inflation adjusted economic burden of infant drug exposure. Prenatal drug exposure and costs was derived from 2014-2016 Texas hospital claims data and 2014-2015 National Inpatient Samples. Linear regressions were used to test the added cost of NAS and prenatal drug exposure (non-NAS) after controlling for a variety of factors. The rate of NAS exposed births has decreased in Texas to 2.5 per 1,000 births in 2016. Between 2014 and 2016, drug exposed births (non-NAS) have increased from 6.1 to 6.7 per 1,000 births in Texas. Nationally, from 2014 to 2015 NAS and drug exposed (non-NAS) has increased from 7.6 to 7.9 per 1,000 and 10.2 to 10.6 per 1,000 births, respectively. In 2016, 74% of the costs associated with NAS exposed infants in Texas were covered by public insurance. In 2016, a non-exposed birth in Texas costs $2,098. When controlling for low birth weight and insurance type, a NAS exposed birth costs $24,889 more, and a drug exposed (non-NAS) cost $3,703 more. In 2015, a non-exposed birth nationally cost $2,052. When controlling for low birthweight and insurance type, a NAS exposed birth costs an additional $12,328, and a drug exposed (non-NAS) cost $517 more. Total economic burden of all infant drug exposure (NAS and Drug Exposed) in Texas totals $66,779,186 in 2016. Nationally, total economic burden of all infant drug exposure (NAS and Drug Exposed) totals $1,033,707,890 in 2015. These results show that infant drug exposure places a substantial societal economic burden on tax payers and social support systems. Texas has lower rates of NAS and infant drug exposure than the nation, but because the longer average length of stay, the average costs are substantially higher. As drug epidemics continue we should attempt to relocate social support investments due to infant drug exposure from treating after birth to preventing before birth.

Subject Area


Recommended Citation

Myers, Matthew G, "Economic Burden of Infant Drug Exposure in Texas" (2018). Texas Medical Center Dissertations (via ProQuest). AAI10789532.