EXHIBIT 5.
Effect of Robust PDMPs on Opioid Prescribing Outcomes among Continuous Enrollees who Received Opioidsa
| Mean Change Baseline to
Follow-Up, Intervention vs. Comparison |
||||
|---|---|---|---|---|
| Absolute | Relative, % | |||
| Est | (95% CI) | Est | (95% CI) | |
| a) Kentucky vs. Missouri (n=55,654) | ||||
| Mean No. Opioid Fills/Enrollee | −0.39 | (−0.46, −0.32)*** | −16.15 | (−18.71, −13.60)*** |
| Mean MED Dispensed/Enrollee | −857.61 | (−1143.93,−571.28)*** | −18.33 | (−23.53,−13.13)*** |
| Percent of Enrollees with Daily MED ≥ 100 |
−0.20 | (−0.32, −0.07)* | −20.42 | (−32.03, −8.80)** |
| Mean Q Opioid Rx Filled with ≥ 3
Doctors/Enrollee |
−0.02 | (−0.02,−0.01)*** | −40.44 | (−50.36, −30.54)*** |
| Mean Q Opioid Rx Filled with ≥ 3
Pharmacies/Enrollee |
−0.01 | (−0.01,−0.00)*** | −38.06 | (−52.72, −23.39)*** |
| b) New Mexico vs. Texas (n=173,860) | ||||
| Mean No. Opioid Fills/Enrollee | −0.14 | (−0.22, −0.05)*** | −6.79 | (−10.16, −3.42)*** |
| Mean MED Dispensed/Enrollee | −270.49 | (−860.69,319.71) | −10.72 | (−17.83,−3.62)** |
| Percent of Enrollees with Daily MED ≥ 100 |
−0.04 | (−0.24, 0.16) | −8.82 | (−23.78, 6.13) |
| Mean Q Opioid Rx Filled with ≥ 3
Doctors/Enrollee |
−0.00 | (−0.01, 0.01) | −6.46 | (−22.92, 10.00) |
| Mean Q Opioid Rx Filled with ≥ 3
Pharmacies/Enrollee |
0.00 | (−0.00, 0.01) | 13.05 | (−10.12, 36.30) |
| c) Tennessee vs. Georgia (n=65,623) | ||||
| Mean No. Opioid Fills/Enrollee | −0.11 | (−0.17, −0.06)*** | −5.23 | (−7.81, −2.79)*** |
| Mean MED Dispensed/Enrollee | −446.60 | (−850.68,−42.53)* | −10.43 | (−16.93,−3.93)** |
| Percent of Enrollees with Daily MED ≥ 100 |
−0.07 | (−0.18, 0.04) | −8.76 | (−19.92, 2.40) |
| Mean Q Opioid Rx Filled with ≥ 3
Doctors/Enrollee |
−0.00 | (−0.01, 0.00) | −2.85 | (−14.53, 8.83) |
| Mean Q Opioid Rx Filled with ≥ 3 Pharmacies/Enrollee | 0.00 | (−0.00, 0.01) | 8.72 | (−10.45, 27.90) |
| d) New York vs. New Jersey (n=50,358) | ||||
| Mean No. Opioid Fills/Enrollee | −0.04 | (−0.09, 0.01)† | −2.93 | (−6.00, 0.14)† |
| Mean MED Dispensed/Enrollee | −232.35 | (−406.63,−58.07)* | −10.54 | (−18.42,−2.67)* |
| Percent of Enrollees with Daily MED ≥ 100 |
−0.03 | (−0.14, 0.09) | −1.43 | (−15.95, 13.09) |
| Mean Q Opioid Rx Filled with ≥ 3
Doctors/Enrollee |
−0.00 | (−0.01, 0.00) | −8.56 | (−23.03, 5.91) |
| Mean Q Opioid Rx Filled with ≥ 3
Pharmacies/Enrollee |
0.00 | (−0.00, 0.01) | 14.81 | (−10.06, 39.68) |
SOURCE: Authors’ analysis of Optum data (OptumInsight, Eden Prairie, MN), 2011–2014.
NOTES: Abbreviations: PDMP, prescription drug monitoring program; MED, morphine equivalent dosage in milligrams; Q, Quarters; Rx, Prescriptions.
All rates/changes estimated using the Stata margins and/or nlcom commands, adjusted for age, gender, race/ethnicity, education-level, poverty-level, and Adjusted Clinical Group score. Mean change baseline to follow up is defined as the difference between the year after and the year before quarter(s) of robust PDMP implementation in the intervention versus comparison state.
Intervention states with robust PDMPs include Kentucky, New Mexico, Tennessee, and New York.
Comparison states include Missouri, Texas, Georgia, and New Jersey.
p<0.1
p<0.05
p<0.01
p<0.001