Original Article

Effect of Payor-Mandated Review of Prescription Drug Monitoring Program on Opioid Prescriber Rates

Authors: Samuel O. Schumann, MD, MSCR, Jingwen Zhang, MS, Jenna L. McCauley, PhD, Khosrow Heidari, MS, Sarah J. Ball, PharmD

Abstract

Objective: To evaluate the effect of a 2016 South Carolina payor mandate to query the state prescription drug monitoring program (PDMP) before prescribing controlled substances on the rate of opioid prescribers in South Carolina.

Methods: South Carolina PDMP datasets from 2010–2017 were evaluated using interrupted time series regression to compare changes in the rate of opioid prescribers before and after the 2016 mandate. The rate of opioid prescribers was defined as the number of prescribers who prescribed class II to IV opioids on any one prescription in each quarter divided by the total number of South Carolina prescribers who prescribed any one class II to IV medication. The rate of high-dose opioid prescribers was defined as the number of prescribers who prescribed ≥90-morphine milligram equivalent per day on any one prescription in each quarter divided by all of the prescribers who prescribed an opioid analgesic prescription.

Results: The rates of South Carolina opioid prescribers decreased from 75% in 2010 to 60% in 2017, with no significant change in slope (P = 0.24) after the 2016 payor mandates. The rates of South Carolina high-dose opioid prescribers decreased from 40% in 2010 to 32% in 2017, with a significant decrease in slope (P < 0.001) after the payor mandate.

Conclusions: The slope of the South Carolina high-dose opioid prescriber rate significantly decreased after the 2016 South Carolina payor mandate, while the slope of the South Carolina opioid prescriber rate did not. The long-term outcomes related to the change in opioid prescriber rates are unknown and warrant further study.

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References

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