Four States With Robust Prescription Drug Monitoring Programs Reduced Opioid Dosages

Health Aff (Millwood). 2018 Jun;37(6):964-974. doi: 10.1377/hlthaff.2017.1321.

Abstract

State prescription drug monitoring programs (PDMPs) aim to reduce risky controlled-substance prescribing, but early programs had limited impact. Several states implemented robust features in 2012-13, such as mandates that prescribers register with the program and regularly check its registry database. Some states allow prescribers to fulfill the latter requirement by designating delegates to check the registry. The effects of robust PDMP features have not been fully assessed. We used commercial claims data to examine the effects of implementing robust PDMPs in four states on overall and high-risk opioid prescribing, comparing those results to trends in similar states without robust PDMPs. By the end of 2014 the absolute mean morphine-equivalent dosages that providers dispensed declined in a range of 6-77 mg per person per quarter in the four states, relative to comparison states. Only in one of the four states, Kentucky, did the percentage of people who filled opioid prescriptions decline versus its comparator state, with an absolute reduction of 1.6 percent by the end of 2014. Robust PDMPs may be able to significantly reduce opioid dosages dispensed, percentages of patients receiving opioids, and high-risk prescribing.

Keywords: Legal/Regulatory Issues; Mental Health/Substance Abuse; Pharmaceuticals; Public Health.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Analgesics, Opioid / supply & distribution*
  • Drug Utilization / statistics & numerical data*
  • Female
  • Humans
  • Insurance Claim Review
  • Insurance Coverage / economics
  • Insurance Coverage / statistics & numerical data*
  • Kentucky
  • Longitudinal Studies
  • Male
  • Missouri
  • New Mexico
  • Opioid-Related Disorders / prevention & control
  • Practice Patterns, Physicians'*
  • Prescription Drug Monitoring Programs / legislation & jurisprudence*
  • Prescription Drugs / supply & distribution
  • Program Development
  • Program Evaluation
  • Retrospective Studies
  • Tennessee
  • United States

Substances

  • Analgesics, Opioid
  • Prescription Drugs