Wen Hefei, Schackman Bruce R, Aden Brandon, Bao Yuhua
Hefei Wen is an assistant professor of health management and policy at the University of Kentucky, in Lexington.
Bruce R. Schackman is a professor of healthcare policy and research at Weill Cornell Medical College, in New York City.
Health Aff (Millwood). 2017 Apr 1;36(4):733-741. doi: 10.1377/hlthaff.2016.1141.
Prescription drug monitoring programs are promising tools to use in addressing the prescription opioid epidemic, yet prescribers' participation in these state-run programs remained low as of 2014. Statutory mandates for prescribers to register with their state's program, use it, or both are believed to be effective tools to realize the programs' full potential. Our analysis of aggregate Medicaid drug utilization data indicates that state mandates for prescriber registration or use adopted in 2011-14 were associated with a reduction of 9-10 percent in population-adjusted numbers of Schedule II opioid prescriptions received by Medicaid enrollees and amounts of Medicaid spending on these prescriptions. This effect was largely associated with mandates of registration, which were comprehensive in all adopting states, and not with mandates of use, which were largely limited in scope or strength before 2015. Our findings support the use of mandates of registration in prescription drug monitoring programs as an effective and relatively low-cost policy. Future research should further assess the value of strong mandates of use to ensure safer and more appropriate prescribing of opioids.
处方药监测计划是应对处方阿片类药物流行的有前景的工具，但截至2014年，开处方者参与这些由州政府运营的计划的比例仍然很低。要求开处方者在其所在州的计划中注册、使用该计划或两者兼有的法定授权被认为是充分发挥这些计划潜力的有效工具。我们对医疗补助计划药物使用汇总数据的分析表明，2011 - 2014年实施的要求开处方者注册或使用的州授权，与医疗补助计划参保者收到的附表II阿片类药物处方的人口调整数量减少9% - 10%以及这些处方的医疗补助支出金额减少有关。这种效果在很大程度上与注册授权相关，所有采用该授权的州都全面实施了注册授权，而与使用授权无关，2015年之前使用授权在范围或力度上大多受到限制。我们的研究结果支持在处方药监测计划中使用注册授权作为一种有效且成本相对较低的政策。未来的研究应进一步评估强有力的使用授权的价值，以确保阿片类药物的处方更安全、更合理。
