Pennsylvania Cuts Prescription Painkiller Rates With Drug Monitoring Program
A prescription drug monitoring program established by the state of Pennsylvania has spurred a substantial decline in the number of prescriptions written for potentially addictive opioids like OxyContin.
The program—which allows physicians and nurses to see if a patient has obtained prescriptions for opioids or other drugs from another medical professional—was authorized by the state legislature in 2014, but did not actually begin operating until June of 2016 due to budget cuts.
But within a few months, insurers began reporting a decline in monthly reimbursements for prescription opioids. Highmark, one of the largest insurers in the state, saw that from January to August 2016, the number of monthly reimbursements hovered between 110,000 to 118,000.
From September to November 2016, Highmark reported that the numbers had dropped to about 107,000. Capital BlueCross reported a “small but continued decrease” during that time period, while UPMC Health Plan said that the number of members receiving at least one opioid prescription dropped from 20% in 2015 to 16% in 2016.
The decline reflects an overall reduction in the number of prescriptions for opioid painkillers written in the United States, which dropped 10% between 2013 and 2015, according to the Washington Post.
Health officials attribute the decline to programs like the Pennsylvania drug monitoring system and greater public awareness about the dangers of prescription opioids.
“What we’re attempting to do here is create a cultural change on how to more safely prescribe,” said Dr. Lauren Hughes, deputy secretary for health innovation for the Pennsylvania Department of Health. “[But] it’s going to take a lot of effort for a long while for us to get there.”
The Pennsylvania program is not without its critics. Prior to its launch, some health providers were worried that casting what they perceived as a negative light on prescription opioids might drive some patients to purchase street drugs like heroin. But Department of Health spokesperson April L. Hutcheson noted that the purpose of the program is to identify patients with potential opioid addiction issues and get them treatment.
“If you need it, your doctor is going to prescribe it,” said Hutcheson. “It’s not preventing opioids from being prescribed; it’s giving prescribers the big picture as to where people are getting their prescriptions from.”
Insurers and health systems in Pennsylvania are currently ramping up their own businesses to identify and assist potential cases of opioid abuse. The health care data assessment company Innovu said that it is performing opioid analysis for “almost all of [its] clients on a monthly or quarterly basis,” while Highmark has added pharmacists to its care management teams to help evaluate and advise therapies for individual cases.