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Payments for Opioids Shifted Substantially to Public and Private Insurers While Consumer Spending Declined, 1999-2012

	photo: prescription pills spilling out of bottle onto moneyA new CDC study reveals that private and public insurers now pay most of the cost for prescription opioids. In 2012, insurers paid 82% of the total cost, compared to just 47% in 1999. At the same time, out-of-pocket cost for prescription opioids (per 100 morphine milligram equivalent or MME) paid by consumers has declined from $4.40 to $0.90. Payers have a financial incentive to reduce inappropriate prescribing and can play a significant role in prescription opioid overdose prevention.

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An analysis of Washington prescription drug monitoring program (PDMP) data revealed that multiple provider episodes (MPEs) vary by age group and class of prescription drug. Opioids and opioid combinations had the highest number of days of overlapping prescriptions, and eight opioids had a mean daily dosage greater than 120 morphine milligram equivalents (MME). Findings indicate that MPEs, overlapping prescription, and mean daily dosages over 100 MMEs are patient risk factors to look for in PDMP data.

Maine’s PDMP data was analyzed to examine several patient risk measures for prescription drug misuse, abuse and overdose. Patients aged 35-54 had the highest rate of MPEs, and opioids were the drug class most frequently involved with MPEs. However, the rate of MPEs declined from 2010 to 2014, and this coincided with an increase in prescribing of buprenorphine, widely used in treating opioid dependence.