Cargando…
Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors
Background The Centers for Disease Control and Prevention (CDC) issued guidelines and certain healthcare payers have made pharmacy coverage changes (PCC) focusing on regulating prescription opioids. Aim We evaluated differences in the rate of first-time opioid fills at doses ≥ 50 morphine milligram...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636786/ https://www.ncbi.nlm.nih.gov/pubmed/34855069 http://dx.doi.org/10.1007/s11096-021-01360-w |
_version_ | 1784608602642710528 |
---|---|
author | Togun, Adeniyi T. Mandic, Pinar Karaca Wurtz, Rebecca Jeffery, Molly Moore Beebe, Timothy |
author_facet | Togun, Adeniyi T. Mandic, Pinar Karaca Wurtz, Rebecca Jeffery, Molly Moore Beebe, Timothy |
author_sort | Togun, Adeniyi T. |
collection | PubMed |
description | Background The Centers for Disease Control and Prevention (CDC) issued guidelines and certain healthcare payers have made pharmacy coverage changes (PCC) focusing on regulating prescription opioids. Aim We evaluated differences in the rate of first-time opioid fills at doses ≥ 50 morphine milligram equivalents (MME)/day and first-time opioid fills with benzodiazepine fill overlap following the CDC guidelines and following a PCC between provider types, geographic locations, and insurance types. Method We used OptumLabs® Data Warehouse claims data between 2014 and 2018. Subjects were opioid naïve non-cancer care patients, 18 years and older who had an identified chronic pain condition ICD diagnosis within 2 weeks prior to their first-time opioid fill. We used multiple treatment period segmented regression analysis with interaction terms to test the differences between primary care providers (PCPs) and specialist providers (SPs), urban and rural primary care service areas (PCSAs), and Medicare Advantage (MA) and commercially insured patients (CIPs) in their first-time opioid fill patterns. Results Prescribing first-time opioid fills at doses ≥ 50MME/day declined following the CDC guidelines and PCC, the decline was greater among SPs than PCPs and in rural PCSAs than urban PCSAs. Also, following the CDC guidelines, the decline was greater among MA patients however following the PCC the decline was greater among CIPs. There were no differences in rate of first-time opioid fill with benzodiazepine overlap between groups. Conclusion Responses to the CDC opioid guidelines and a PCC differed between PCPs and SPs, urban and rural PCSAs, and when prescribing to MA and CIPs. Understanding these differences is important to help inform future guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11096-021-01360-w. |
format | Online Article Text |
id | pubmed-8636786 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-86367862021-12-02 Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors Togun, Adeniyi T. Mandic, Pinar Karaca Wurtz, Rebecca Jeffery, Molly Moore Beebe, Timothy Int J Clin Pharm Research Article Background The Centers for Disease Control and Prevention (CDC) issued guidelines and certain healthcare payers have made pharmacy coverage changes (PCC) focusing on regulating prescription opioids. Aim We evaluated differences in the rate of first-time opioid fills at doses ≥ 50 morphine milligram equivalents (MME)/day and first-time opioid fills with benzodiazepine fill overlap following the CDC guidelines and following a PCC between provider types, geographic locations, and insurance types. Method We used OptumLabs® Data Warehouse claims data between 2014 and 2018. Subjects were opioid naïve non-cancer care patients, 18 years and older who had an identified chronic pain condition ICD diagnosis within 2 weeks prior to their first-time opioid fill. We used multiple treatment period segmented regression analysis with interaction terms to test the differences between primary care providers (PCPs) and specialist providers (SPs), urban and rural primary care service areas (PCSAs), and Medicare Advantage (MA) and commercially insured patients (CIPs) in their first-time opioid fill patterns. Results Prescribing first-time opioid fills at doses ≥ 50MME/day declined following the CDC guidelines and PCC, the decline was greater among SPs than PCPs and in rural PCSAs than urban PCSAs. Also, following the CDC guidelines, the decline was greater among MA patients however following the PCC the decline was greater among CIPs. There were no differences in rate of first-time opioid fill with benzodiazepine overlap between groups. Conclusion Responses to the CDC opioid guidelines and a PCC differed between PCPs and SPs, urban and rural PCSAs, and when prescribing to MA and CIPs. Understanding these differences is important to help inform future guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11096-021-01360-w. Springer International Publishing 2021-12-02 2022 /pmc/articles/PMC8636786/ /pubmed/34855069 http://dx.doi.org/10.1007/s11096-021-01360-w Text en © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Research Article Togun, Adeniyi T. Mandic, Pinar Karaca Wurtz, Rebecca Jeffery, Molly Moore Beebe, Timothy Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors |
title | Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors |
title_full | Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors |
title_fullStr | Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors |
title_full_unstemmed | Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors |
title_short | Association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors |
title_sort | association of opioid fills with centers for disease control and prevention opioid guidelines and payer coverage policies: physician, insurance and geographic factors |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636786/ https://www.ncbi.nlm.nih.gov/pubmed/34855069 http://dx.doi.org/10.1007/s11096-021-01360-w |
work_keys_str_mv | AT togunadeniyit associationofopioidfillswithcentersfordiseasecontrolandpreventionopioidguidelinesandpayercoveragepoliciesphysicianinsuranceandgeographicfactors AT mandicpinarkaraca associationofopioidfillswithcentersfordiseasecontrolandpreventionopioidguidelinesandpayercoveragepoliciesphysicianinsuranceandgeographicfactors AT wurtzrebecca associationofopioidfillswithcentersfordiseasecontrolandpreventionopioidguidelinesandpayercoveragepoliciesphysicianinsuranceandgeographicfactors AT jefferymollymoore associationofopioidfillswithcentersfordiseasecontrolandpreventionopioidguidelinesandpayercoveragepoliciesphysicianinsuranceandgeographicfactors AT beebetimothy associationofopioidfillswithcentersfordiseasecontrolandpreventionopioidguidelinesandpayercoveragepoliciesphysicianinsuranceandgeographicfactors |