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Center for Health Services and Outcomes Research

Health Policy

Impact of "Pill Mill" Laws on Opioid Prescribing, Dispensing and Utilization

In an effort to reduce prescription drug abuse, especially of opioids, while not obstructing clinically appropriate treatments, states are increasingly pursuing legislation known as “pill mill” laws, aimed at restricting the clinical operations of health care clinics that account for disproportionately high volumes of opioid and other controlled substance prescribing. Capitalizing upon a database of approximately 5.2 billion longitudinal prescription claims for more than 50 million Americans and 1.5 million prescribers from 2006 through 2013, we are examining the aggregate impact of these laws.

The data are particularly well suited for the current analyses, since they capture prescriptions for all sources of payment including cash payment; include a prescriber and pharmacy identifier and also capture prescribing by licensed non-physicians such as dentists and nurse practitioners; extend longitudinally over an eight year period; reflect more than 65% of all prescriptions dispensed in the states of interest; and allow for granular geographic analyses and can be combined with other data to examine policy effects.  We are also characterizing their effect on subsets of patients, prescribers and pharmacies whose baseline measures suggest unusual patterns of utilization, prescribing or dispensing.

PUBLICATIONS:

Chang H‐Y, Murimi I, Faul M, Rutkow L, Alexander GC. Impact of Florida's prescription drug monitoring program and pill mill law on high‐risk patients: A comparative interrupted time series analysisPharmacoepidemiol Drug Saf2018;27:422–429. https://doi.org/10.1002/pds.4404

Rutkow L, Smith KC, Lai AY, Vernick JS, Davis CS, Alexander GC. Prescription drug monitoring program design and function: A qualitative analysis. Drug Alcohol Depend 2017;180:395–400. https://doi.org/10.1016/j.drugalcdep.2017.08.040

Moyo P., Simoni‐Wastila L., Griffin B. A., Onukwugha E., Harrington D., Alexander G. C. et alImpact of prescription drug monitoring programs (PDMPs) on opioid utilization among Medicare beneficiaries in 10 US statesAddiction 2017https://doi.org/10.1111/add.13860

Lin DHLucas EMurimi IBJackson KBaier MFrattaroli SGielen ACMoyo PSimoni-Wastila LAlexander GC. 2017 Physician attitudes and experiences with Maryland’s prescription drug monitoring program (PDMP) Addiction, 112 (2) (2017), pp. 311-319. https://doi.org/10.1111/add.13620