دانلود رایگان مقاله گرایشات در میانگین روزهای عرضه داروهای اپیوئید در بیمه های سلامت و تجاری

abstract

Objectives To calculate trends in adult average days’ supply for six commonly prescribed opioids: hydrocodone, hydromorphone, morphine, oxycodone, oxymorphone, and tapentadol to assess whether physicians changed prescribing practices at the time of the intensifying epidemic. Methods We used 2005–2015 Truven Health MarketScan Commercial Claims and Encounters data to measure trends in opioid average days’ supply among commercially insured individuals and 2005–2014 MarketScan Multi-State Medicaid data to measure trends in opioid average days’ supply among Medicaid beneficiaries. Results For Medicaid, we found an increase in days’ supply for all drugs except morphine. The largest percentage increase was for oxycodone, which increased 4.5 days (37%). Opioid days’ supply for individuals with commercial insurance exhibited similar but steeper trends. The largest increase was also for oxycodone, which increased 6 days (56%). Between 2013 and 2015, when the opioid epidemic had begun to be widely publicized, there was no decline in the median days supplied for any of the opioids.

4. Discussion

Despite national headlines describing the perils of opioid addiction, increased provider education about opioid prescribing, and regulations to restrict the number of pills prescribed, the days’ supply of prescriptions for commonly prescribed opioids significantly increased in the last decade as well as more recently (from 2013 to 2014 or 2015). Given that there are more than 250 million prescriptions for opioid pain medications, even an average one-day decrease in days supplied could have a significant effect on reducing the impact of opioids on public health. (CDC, 2014) These results suggest that more needs to be done to reduce opioid prescribing to only the short period necessary for acute pain. For example, evidence based provider outreach and education may help convey to providers and patients that, given the risks of abuse and lack of a strong evidence base for long-term efficacy, opioids should be prescribed sparingly. Future research should continue to track trends in opioid pain medication days supplied and should assess the impact of policies to reduce days supplied on opioid misuse, addiction, and overdose.