PDMPS: An effective but underutilized resource for prescribers

MCOs are going to have to step up their efforts to impact the growing opioid epidemic in this country.

“What we are seeing is a failure on the part of too many providers to carefully weigh pain management options before writing a prescription for a seriously addictive drug,” says Managed Healthcare Executive Editorial Advisor Don Hall, a former health plan CEO, and principal, Delta Sigma LLC, in Littleton, Colorado. “This is where the value of medication therapy management programs could be effective.”

As the nation’s opioid epidemic continues to intensify, consider joining trailblazers from health plans, pharmacies and healthcare companies at CBI’s inaugural Prescription Drug Monitoring Programs. This summit will focus on the crucial elements of managing how drugs are prescribed, dispensed and reimbursed.

“Balancing Access and Use of Opioid Therapy,” a pre-conference program presented at the Academy of Managed Care Pharmacy (AMCP) Nexus on October 3, in National Harbor, Maryland, examined the growing challenges and societal impacts associated with chronic pain treatment and the potential for abuse and addiction.

Reilly

Presenter Cynthia Reilly, director of The Pew Charitable Trusts' substance use prevention and treatment initiative, talked about the challenges with balancing access and use of opioid therapy.

“Not enough prescribers are using prescription drug monitoring programs [PDMPs]-state-based databases that can help ensure patients have access to safe, effective pain management while also protecting these individuals from unsafe amounts or combinations of these drugs,” Reilly told Managed Healthcare Executive. “Making these tools easier to use can help increase prescriber use and achieve this balance.”

According to the National Institute on Drug Abuse, opioid pain relievers are generally safe when taken for a short time and as prescribed by a physician, but they are frequently misused because they produce euphoria in addition to pain relief.

The number of opioid painkillers sold in the U.S. over the past 20 years, has risen noticeably. This rise in sales was accompanied by an increase in opioid-related overdose deaths. Given this, 49 states (all but Missouri) created PDMPs to detect high-risk prescribing and patient behaviors.

A recent study, published in Health Affairs, found that PDMPs that monitored greater numbers of drugs with abuse potential and updated their data more frequently had an average reduction of 1.12 opioid-related overdose deaths per 100,000 population in the year after implementation than programs without those characteristics.

“A growing body of evidence suggests that certain strategies-such as allowing delegates to access the database on a prescriber’s behalf-can make PDMPs more clinically relevant and increase use,” Reilly said. “Some states are exploring other practices, such as prescriber-set thresholds, which allow clinicians to choose when they receive alerts about patients whose prescribing history indicates they may be at risk of harm.”