Decline in opioid prescribing after federal rescheduling of hydrocodone products

Abstract

The 2014 federal policy was associated with a decrease in rates of HCP and total opioid prescribing. The large decrease in the rates of HCP prescribing for patients with actively treated cancer may represent an unintended consequence.

Opioid Prescriptions in Older Medicare Beneficiaries After the 2014 Federal Rescheduling of Hydrocodone Products

“…Using pharmacy data, one study reported a 22% fewer dispensed hydrocodone combination product prescriptions in the 12 months after than the 12 months before rescheduling. We have previously reported a 26% relative decrease in hydrocodone prescriptions from a monthly rate of 2.7% in 2013 to 2.0% in 2015 in a commercially insured population aged 18 to 64 . This compares with a 18.7% relative decrease in monthly rate of hydrocodone prescription from 7.2% in 2013 to 5.8% in 2015 that we found in the older Medicare population.…”

“…Although some single centers reported an increase in tramadol prescribing after the rescheduling, our findings of no change in tramadol prescribing are similar to our previous nationwide study in a younger, commercially insured population …”

“…A national study using data from U.S. pharmacies also reported a decrease in prescribing rates for hydrocodone and prescription opioids overall from 2011 to 2015 . In our previous study using national commercial health insurance data for individuals aged 18 to 64, we reported a 26% relative decrease in hydrocodone prescribing and an 11% relative decrease in total opioid prescribing from 2013 to 2015 …”

Using trajectory models to assess the effect of hydrocodone upscheduling among chronic hydrocodone users

“…This finding is consistent with previous studies that have that shown limited substitution effects among closed cohorts of HCP users that were analyzed before and after the schedule change . Studies that have reported increases in the use of alternative analgesics after HCP rescheduling have been primarily set in emergency departments, poison control centers and single provider outpatient settings, and their findings are likely to represent the impact of system‐level changes on both new and continuing HCPs users .…”

“…Several studies have examined in the impact of the hydrocodone schedule change on opioid prescribing. These studies have consistently demonstrated that the upscheduling decreased the prescribing and dispensing of both hydrocodone combination products and opioids in general . For example, an analysis of nationwide prescription sales data indicated that the schedule change was associated with 1.1 billion fewer hydrocodone combination product tablets and 26.3 million fewer prescriptions during the year after it went into effect .…”