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Decline in opioid prescribing after federal rescheduling of hydrocodone products.
Pharmacoepidemiol Drug Saf. 2018 05; 27(5):513-519.PD

Abstract

PURPOSE

To examine differences in opioid prescribing by patient characteristics and variation in hydrocodone combination product (HCP) prescribing attributed to states, before and after the 2014 Drug Enforcement Administration's reclassification of HCP from schedule III to the more restrictive schedule II.

METHODS

We used 2013 to 2015 data for 9 202 958 patients aged 18 to 64 from a large nationally representative commercial health insurance program to assess the temporal trends in the monthly rate of opioid prescribing.

RESULTS

HCP prescribing decreased by 26% from June 2013 to June 2015; the rate of prescriptions for any opioid decreased by 11%. Prescribing of non-hydrocodone schedule III opioids increased slightly while prescribing of non-hydrocodone schedule II opioids and tramadol was stable. Absolute decreases in HCP prescribing rates were larger in patients being treated for cancer (-2.26% vs -0.7% for non-cancer patients, P < 0.0001) and in those with high comorbidities (-2.13% vs -0.55% for those with no comorbidity, P < 0.0001). Differences in the absolute and relative changes in HCP prescribing rates among states were large; for example, a relative decrease of 46.7% in Texas and a 12.7% increase in South Dakota. The variation in HCP prescribing attributable to the state of residence increased from 6.6% in 2013 to 8.7% in 2015.

CONCLUSIONS

The 2014 federal policy was associated with a decrease in rates of HCP and total opioid prescribing. The large decrease in the rates of HCP prescribing for patients with actively treated cancer may represent an unintended consequence.

Authors+Show Affiliations

Department of Internal Medicine and Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, 77555-1148, USA.Department of Internal Medicine and Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, 77555-1148, USA. Institute for Translational Science, University of Texas Medical Branch, Galveston, TX, 77555-0342, USA. Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, 77555-1148, USA.Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, 77555-1148, USA.Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, 77555-1148, USA. Institute for Translational Science, University of Texas Medical Branch, Galveston, TX, 77555-0342, USA. Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, 77555-1148, USA.Department of Internal Medicine and Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA. Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, 77555-1148, USA. Institute for Translational Science, University of Texas Medical Branch, Galveston, TX, 77555-0342, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

29271049

Citation

Raji, Mukaila A., et al. "Decline in Opioid Prescribing After Federal Rescheduling of Hydrocodone Products." Pharmacoepidemiology and Drug Safety, vol. 27, no. 5, 2018, pp. 513-519.
Raji MA, Kuo YF, Adhikari D, et al. Decline in opioid prescribing after federal rescheduling of hydrocodone products. Pharmacoepidemiol Drug Saf. 2018;27(5):513-519.
Raji, M. A., Kuo, Y. F., Adhikari, D., Baillargeon, J., & Goodwin, J. S. (2018). Decline in opioid prescribing after federal rescheduling of hydrocodone products. Pharmacoepidemiology and Drug Safety, 27(5), 513-519. https://doi.org/10.1002/pds.4376
Raji MA, et al. Decline in Opioid Prescribing After Federal Rescheduling of Hydrocodone Products. Pharmacoepidemiol Drug Saf. 2018;27(5):513-519. PubMed PMID: 29271049.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decline in opioid prescribing after federal rescheduling of hydrocodone products. AU - Raji,Mukaila A, AU - Kuo,Yong-Fang, AU - Adhikari,Deepak, AU - Baillargeon,Jacques, AU - Goodwin,James S, Y1 - 2017/12/21/ PY - 2017/06/19/received PY - 2017/10/16/revised PY - 2017/11/20/accepted PY - 2017/12/23/pubmed PY - 2019/9/17/medline PY - 2017/12/23/entrez KW - laws KW - opioids KW - pharmacoepidemiology KW - public policy SP - 513 EP - 519 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 27 IS - 5 N2 - PURPOSE: To examine differences in opioid prescribing by patient characteristics and variation in hydrocodone combination product (HCP) prescribing attributed to states, before and after the 2014 Drug Enforcement Administration's reclassification of HCP from schedule III to the more restrictive schedule II. METHODS: We used 2013 to 2015 data for 9 202 958 patients aged 18 to 64 from a large nationally representative commercial health insurance program to assess the temporal trends in the monthly rate of opioid prescribing. RESULTS: HCP prescribing decreased by 26% from June 2013 to June 2015; the rate of prescriptions for any opioid decreased by 11%. Prescribing of non-hydrocodone schedule III opioids increased slightly while prescribing of non-hydrocodone schedule II opioids and tramadol was stable. Absolute decreases in HCP prescribing rates were larger in patients being treated for cancer (-2.26% vs -0.7% for non-cancer patients, P < 0.0001) and in those with high comorbidities (-2.13% vs -0.55% for those with no comorbidity, P < 0.0001). Differences in the absolute and relative changes in HCP prescribing rates among states were large; for example, a relative decrease of 46.7% in Texas and a 12.7% increase in South Dakota. The variation in HCP prescribing attributable to the state of residence increased from 6.6% in 2013 to 8.7% in 2015. CONCLUSIONS: The 2014 federal policy was associated with a decrease in rates of HCP and total opioid prescribing. The large decrease in the rates of HCP prescribing for patients with actively treated cancer may represent an unintended consequence. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/29271049/Decline_in_opioid_prescribing_after_federal_rescheduling_of_hydrocodone_products_ L2 - https://doi.org/10.1002/pds.4376 DB - PRIME DP - Unbound Medicine ER -