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Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy.

Publication ,  Journal Article
Roberts, AW; Farley, JF; Holmes, GM; Oramasionwu, CU; Ringwalt, C; Sleath, B; Skinner, AC
Published in: Health Aff (Millwood)
October 1, 2016

Controlled substance lock-in programs are garnering increased attention from payers and policy makers seeking to combat the epidemic of opioid misuse. These programs require high-risk patients to visit a single prescriber and pharmacy for coverage of controlled substance medication services. Despite high prevalence of the programs in Medicaid, we know little about their effects on patients' behavior and outcomes aside from reducing controlled substance-related claims. Our study was the first rigorous investigation of lock-in programs' effects on out-of-pocket controlled substance prescription fills, which circumvent the programs' restrictions and mitigate their potential public health benefits. We linked claims data and prescription drug monitoring program data for the period 2009-12 for 1,647 enrollees in North Carolina Medicaid's lock-in program and found that enrollment was associated with a roughly fourfold increase in the likelihood and frequency of out-of-pocket controlled substance prescription fills. This finding illuminates weaknesses of lock-in programs and highlights the need for further scrutiny of the appropriate role, optimal design, and potential unintended consequences of the programs as tools to prevent opioid abuse.

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Published In

Health Aff (Millwood)

DOI

EISSN

1544-5208

Publication Date

October 1, 2016

Volume

35

Issue

10

Start / End Page

1884 / 1892

Location

United States

Related Subject Headings

  • United States
  • Policy
  • Opioid-Related Disorders
  • Medicaid
  • Humans
  • Health Policy & Services
  • Health Expenditures
  • Drug-Seeking Behavior
  • Drug and Narcotic Control
  • Controlled Substances
 

Citation

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Roberts, A. W., Farley, J. F., Holmes, G. M., Oramasionwu, C. U., Ringwalt, C., Sleath, B., & Skinner, A. C. (2016). Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy. Health Aff (Millwood), 35(10), 1884–1892. https://doi.org/10.1377/hlthaff.2016.0355
Roberts, Andrew W., Joel F. Farley, G Mark Holmes, Christine U. Oramasionwu, Chris Ringwalt, Betsy Sleath, and Asheley C. Skinner. “Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy.Health Aff (Millwood) 35, no. 10 (October 1, 2016): 1884–92. https://doi.org/10.1377/hlthaff.2016.0355.
Roberts AW, Farley JF, Holmes GM, Oramasionwu CU, Ringwalt C, Sleath B, et al. Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy. Health Aff (Millwood). 2016 Oct 1;35(10):1884–92.
Roberts, Andrew W., et al. “Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy.Health Aff (Millwood), vol. 35, no. 10, Oct. 2016, pp. 1884–92. Pubmed, doi:10.1377/hlthaff.2016.0355.
Roberts AW, Farley JF, Holmes GM, Oramasionwu CU, Ringwalt C, Sleath B, Skinner AC. Controlled Substance Lock-In Programs: Examining An Unintended Consequence Of A Prescription Drug Abuse Policy. Health Aff (Millwood). 2016 Oct 1;35(10):1884–1892.

Published In

Health Aff (Millwood)

DOI

EISSN

1544-5208

Publication Date

October 1, 2016

Volume

35

Issue

10

Start / End Page

1884 / 1892

Location

United States

Related Subject Headings

  • United States
  • Policy
  • Opioid-Related Disorders
  • Medicaid
  • Humans
  • Health Policy & Services
  • Health Expenditures
  • Drug-Seeking Behavior
  • Drug and Narcotic Control
  • Controlled Substances