“Kill the Refill”: Combating Post-Surgery Opioid Harms and Costs by Attacking a Hidden Villain
A quarter century into the Opioid Crisis in America, nearly every person, family, and community has been touched by the Crisis in some way. Prescription opioids continue to fuel this epidemic, including when patients are introduced to opioids via a key gateway, surgery.
Goldfinch Health has supported patients preparing for and recovering from major surgery since 2018. Through thousands of supported cases, we’ve listened—to the patients; to our employer, labor union, and insurer clients; to healthcare professionals; and to the data.
Today, we announce a new initiative based on our findings. We have unmasked a previously-overlooked villain that is driving costs up and endangering patients—the post-surgery opioid refill.
The Hidden Villain
A single opioid refill after surgery doubles a patient’s risk for continued opioid use one year later. This simple act—calling the doctor for more pain medication—leads to devastating consequences for millions.
The numbers tell a troubling story:
- 45% of orthopedic patients receive at least one opioid refill within 90 days
- 25% of all surgery patients get a refill
- 6-10% of surgery patients become persistent opioid users
The True Cost
The cost of a prescription opioid refill is typically around $10. The financial impact extends far beyond this initial sticker price:
- In the 90 days after surgery, patients with an opioid refill are more likely to experience readmissions and other expensive care failures.
- This leads to opioid refillers incurring $5,645 more in healthcare costs than patients with no refills, in the three months following surgery.
- Opioid refillers are also at increased risk of long-term opioid use. The average cost per opioid use disorder case is $221,219.
These costs stem from complications few recognize. Opioids:
- Increase risk of infections and blood clots
- Create environments for cancer growth
- Cause breastfeeding difficulties
- Lead to cognitive dysfunction, especially in older patients
- And, ironically, cause pain.
Community Impact
Each year, 3 billion prescribed opioid pills go unused—that’s 10 pills for every American. These leftover medications become dangerous:
- 80% of illicit drug users start with leftover prescription pills
- Opioids account for 52% of poisoning-related deaths in children under 5
Our Insight
If we can get upstream, through a systematic and patient-friendly approach to better treating pain and supporting patients before and after surgery, we can help to reduce the risk of these substantial harms. And we can help labor unions, employers and others to administer higher-quality, lower-cost plans.
We must KILL THE REFILL!
Here’s how we do it:
- Advocating for Enhanced Recovery Protocols: Evidence-based approaches that minimize opioid use
- Preparing Patients: Setting proper expectations about pain before surgery, through education
- Providing Critical Support: Guidance during the crucial 3-5 days post-surgery
- Eliminating Leftover Medications: Education and tools for proper disposal
Join the Billion Pill Pledge
We’ve launched the Billion Pill Pledge—a movement to erase one billion opioid pills from our communities by better treating pain and right-sizing initial prescriptions, eliminating unnecessary refills, and safely disposing of leftover medications.
Why This Matters
For employers and unions, addressing post-surgery opioid use offers a rare win-win:
- Protect your people from addiction
- Reduce healthcare costs by thousands of dollars per surgery
- Support faster return to work and life
- Create safer communities
Visit billionpillpledge.com to join our mission!