Comprehensive prescription drug monitoring program mandates reduce opioid prescribing in hospitals
State mandates that require both prescribers and dispensers to enter and use prescription drug monitoring programs led to greater reductions in opioid prescriptions and opioid-related hospital use compared with states that had less strict or no mandates, according to a study published in Health Affairs.
“Our findings contribute significant evidence in support of comprehensive mandates for reducing the use of opioid prescriptions by Medicaid patients, a population with an elevated risk for opioid misuse and overdose compared to patients with other insurance status,” Yuhua Boa, PhD, associate professor of health care policy and research at Weill Cornell Medical College, said in the press release.
According to Boa and colleagues, prescription drug monitoring programs are a promising strategy for curbing opioid prescriptions and slowing the epidemic.
“These statewide electronic databases collect and monitor prescribing and dispensing information on controlled substances to help providers identify high-risk people and high-risk patterns such as high-dosage prescriptions, dangerous drug combinations, and multiple-provider episodes,” they wrote.
To evaluate the effects of prescription drug monitoring program mandates on opioid prescribing among Medicaid patients, the researchers reviewed CMS data from 2011 through 2016. They used a separate database to collect information on opioid-related inpatient stays and ED visits during the study period.
They found that, between 2011 and 2016, states with prescription drug monitoring program mandates experienced an 8.92% reduction in the number of opioid prescriptions. During that time, there was a 4.7% reduction in opioid-related hospital stays and a 17.75% reduction in opioid-related ED visits.
Similar reductions were not seen in states with noncomprehensive mandates.
The reductions in opioid-related hospital stays and ED visits associated with comprehensive mandates equates to 12,000 fewer hospital stays and 39,000 fewer ED visits per year, according to researchers, who estimated that these reductions could save approximately $155 million in Medicaid spending each year.
“This is one of a few studies that have examined the downstream effects of prescription drug monitoring mandates, using data that capture recent experience with comprehensive mandates,” Bao said in the press release. “We hope our findings will inform state policy discussions for strengthening prescription drug monitoring programs to address the opioid crisis more effectively.” – by Erin Michael
Disclosures: Bao was supported by a pilot grant from the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV and HIV (CHERISH). Please see study for all other authors’ relevant financial disclosures.