ArticleAddiction (Abingdon, England)2018
Effects of a prior authorization policy for extended-release/long-acting opioids on utilization and outcomes in a state Medicaid program.
Article in Addiction (Abingdon, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evidence for state, community and systems-level prevention strategies to address the opioid crisis.Drug and alcohol dependence · 2019Pooled it
- US payment policy for medications to treat opioid use disorder: landscape and opportunities.Health affairs scholar · 2024Article
- Systematic Identification and Categorization of Opioid Prescribing and Dispensing Policies in 16 States and Washington, DC.Pain medicine (Malden, Mass.) · 2023Article
- Medicare Part D Coverage Restrictions and Patient Cost-Sharing for Opioids Commonly Used for Cancer Pain, 2015-2021.JCO oncology practice · 2022Article
- Evaluation of Prior Authorization in Medicare Nonemergent Ambulance Transport.JAMA health forum · 2022Article
- Association of opioid utilization management with prescribing and overdose.The American journal of managed care · 2022Article
- Evaluation of a Medicaid performance improvement project to reduce high-dose opioid prescriptions.BMC health services research · 2022Article
- Changes in postoperative opioid prescribing across three diverse healthcare systems, 2010-2020.Frontiers in digital health · 2022Article
- Prescription quantity and duration predict progression from acute to chronic opioid use in opioid-naïve Medicaid patients.PLOS digital health · 2022Article
- Trends and risk factors for opioid administration for non-emergent lower back pain.World journal of orthopedics · 2021Article
- Impact of drug utilization management policy on prescription opioid use in Georgia Medicaid.Journal of pharmaceutical health services research : an official journal of the Royal Pharmaceutical Society of Great Britain · 2021Article
- Changes in early high-risk opioid prescribing practices after policy interventions in Washington State.Health services research · 2021Article
- Misalignment of Stakeholder Incentives in the Opioid Crisis.International journal of environmental research and public health · 2020Review
- The state of the science in opioid policy research.Drug and alcohol dependence · 2020Review
- A comparison of trends in opioid dispensing patterns between Medicaid pharmacy claims and prescription drug monitoring program data.Pharmacoepidemiology and drug safety · 2020Article
- The Association of State Opioid Misuse Prevention Policies With Patient- and Provider-Related Outcomes: A Scoping Review.The Milbank quarterly · 2020Article
- Reducing High-Dose Opioid Prescribing: State-Level Morphine Equivalent Daily Dose Policies, 2007-2017.Pain medicine (Malden, Mass.) · 2020Article
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
aimsIn response to the opioid overdose epidemic, US state Medicaid programs have adopted restrictive policies for opioid analgesics, yet effects on prescribing patterns and health outcomes are uncertain. This study aimed to examine effects of a prior authorization policy for extended-release/long-acting (ER/LA) opioids on opioid use in the Oklahoma, USA state Medicaid program.
designRetrospective difference-in-differences design study comparing changes in opioid use in Oklahoma Medicaid to control (Oregon Medicaid).
settingOklahoma and Oregon, USA.
participantsMedicaid beneficiaries in the Oklahoma and Oregon fee-for-service Medicaid programs between July 2007 and June 2009 (33 724 in Oklahoma and 13 520 in Oregon) MEASUREMENTS: The primary outcome was incident opioid-naive ER/LA opioid use. Secondary outcomes included other opioid and non-opioid pain medication use. We also examined indicators of high-risk prescribing (e.g. high-dosage opioid use) and opioid-related hospitalizations or emergency department (ED) visits.
findingsThe prior authorization policy was associated with a 0.7 percentage point reduction in the likelihood of incident opioid-naive ER/LA opioid use [95% confidence interval (CI) = -1.16 to -0.33 percentage points; 70% pre-policy mean reduction, a 1.4 percentage point decrease in likelihood of any new ER/LA opioid prescriptions (95% CI = -2.1 to -0.7 percentage points; 33% pre-policy mean reduction) and a decline of 0.16 in total ER/LA opioid prescriptions per enrollee (PPE) (95% CI = -0.29 to -0.04 PPE)]. There was a significant increase in the number of short-acting opioids filled after the policy (0.36; 95% CI = 0.22-0.50 PPE), increases in likelihood of having overlapping opioids and benzodiazepines, but significant reductions in likelihood of having overlapping opioids. No significant changes in opioid-related hospitalizations or ED visits were observed.
conclusionsIn Oklahoma, USA's July 2008 prior authorization policy for extended-release/long-acting opioids appears to have reduced the number of opioid-naive patients initiating extended-release/long-acting opioid use by more than half, but may also have increased short-acting opioid prescriptions by 7%.
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