Evidence map›Paper›PMID 31631255›Full record

ArticlePharmacoEconomics2020

The Value of Shorter Initial Opioid Prescriptions: A Simulation Evaluation.

Margrét V Bjarnadóttir, David R Anderson, Kislaya Prasad, Ritu Agarwal, D Alan Nelson

Abstract read
PubMed Publisher
In one paragraph

Article in PharmacoEconomics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Margrét V BjarnadóttirRobert H. Smith School of Business, Decision, Operations, and Information Technologies, University of Maryland, College Park, MD, USA. margret@rhsmith.umd.edu.ORCID 0000-0003-2955-1992
David R AndersonSchool of Business, Management and Operations, Villanova University, Villanova, PA, USA.ORCID 0000-0002-1128-6206
Kislaya PrasadRobert H. Smith School of Business, Decision, Operations, and Information Technologies, University of Maryland, College Park, MD, USA.ORCID 0000-0002-7796-3310
Ritu AgarwalRobert H. Smith School of Business, Decision, Operations, and Information Technologies, University of Maryland, College Park, MD, USA.ORCID 0000-0002-8907-5652
D Alan NelsonDivision of Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA.ORCID 0000-0001-5717-8190

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring the period from 1999 to 2016, more than 350,000 Americans died from overdoses related to the use of prescription opioids. To the extent that supply is directly related to overprescribing, policy interventions aimed at changing prescriber behavior, such as the recent Centers for Disease Control and Prevention guideline, are clearly warranted. Although these could plausibly reduce the prevalence of opioid overuse and dependency, little is known about their economic and health-related impacts.

objectiveThe aim of this study was to quantify the efficacy of a policy intervention aimed at reducing the length of initial opioid prescriptions. STUDY DESIGN AND

methodsA Markov decision process model was fitted on a retrospective cohort of 827,265 patients, and patient cost and health trajectories were simulated over a 24-month period. The model's parameters were based on patients who received short (≤ 3 days) or long (> 7 days) initial opioid prescriptions, matched using propensity score methods. STUDY POPULATION: All active-duty US Army soldiers from 2011 to 2014; the data contained detailed medical and administrative information on over 11 million soldier-months corresponding to 827,265 individual soldiers.

main outcome measureOverall costs of a policy change, quality-adjusted life-years (QALYs) gained, and $/QALY gained.

resultsOver a 2-year horizon, a reassignment of 10,000 patients to short initial duration would generate a cost saving in the vicinity of $3.1 million (excluding program costs), and would also lead to an estimated 4451 additional opioid-free months, i.e. months without any opioid prescriptions.

conclusionThe analysis found that efforts to change prescriber behavior can be cost effective, and further studies into the implementation of such policies are warranted.

Indexed as

Decision Support TechniquesModels, EconomicAnalgesics, OpioidCost-Benefit AnalysisDrug PrescriptionsHumansPractice Patterns, Physicians'Quality-Adjusted Life YearsRetrospective StudiesAnalgesics, Opioid

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.