States With Prescription Drug Monitoring Mandates Saw A Reduction In Opioids Prescribed To Medicaid Enrollees

Abstract

Prescription drug monitoring programs are promising tools to use in addressing the prescription opioid epidemic, yet prescribers’ participation in these state-run programs remains low as of 2014. Statutory mandates for prescribers to register with their state’s program, use it, or both are believed to be effective tools to realize the programs’ full potential. Our analysis of aggregate Medicaid drug utilization data indicates that state mandates for prescriber registration or use adopted in 2011–14 were associated with a reduction of 9–10 percent in population-adjusted numbers of Schedule II opioid prescriptions received by Medicaid enrollees and amounts of Medicaid spending on these prescriptions. This effect was largely associated with mandates of registration, which were comprehensive in all adopting states, and not with mandates of use, which were largely limited in scope or strength before 2015. Our findings support the use of mandates of registration in prescription drug monitoring programs as an effective and relatively low-cost policy. Future research should further assess the value of strong mandates of use to ensure safer and more appropriate prescribing of opioids.

Commentary on Pardo (2017) and Moyo et al. (2017): Much still unknown about prescription drug monitoring programs

“…Consistent with previous research, changes were found to vary dramatically between states and subgroups, and were limited largely to Schedule II opioids [3][4][5][6]. In a country where opioid prescribing nearly quadrupled from 1999 to 2008, it seems likely that much larger and more broad-based declines will be necessary to move the needle significantly on OA-related overdose [7].…”

A path out: Prescription drug abuse, treatment, and suicide

“…One of the largest and most comprehensive studies of prescribing behavior, Buchmueller and Carey (2018), uses Medicare Part D data from 2007-2012 to examine patients' prescription histories. This paper finds that PDMPs have the intended effect on supply, reducing the percentage of enrollees who obtain prescriptions from five or more physicians by more than 8 percent and from five or more pharmacies by more than 15 percent, with no effect on 13 For evidence on Schedule II prescriptions, see Bao et al (2016), Moyo et al (2017), and Wen et al (2017). 7 the mean of the utilization distribution.…”

Risk Assessment and Monitoring of Patients with Cancer Receiving Opioid Therapy

“…Universal precautions may include several strategies, including the use of urine toxicology , standardized contracts or agreements , and review of the data accessed from the state PDMP . More information is needed regarding which of these strategies are most beneficial, as well as cost and time effective, in the oncology setting.…”