Opioids in Georgia Medicaid: Gender and Insurance Disparities in Utilization and Potential Inappropriate Prescribing...

Area of Science:

• Public Health
• Health Services Research
• Pharmacoeconomics

Background:

• The opioid epidemic disproportionately impacts Medicaid populations.
• Georgia has seen opioid-related deaths rise at more than double the national rate.
• Understanding disparities in opioid prescribing within Georgia's Medicaid population is crucial.

Purpose of the Study:

• To examine gender and insurance disparities in opioid use among Georgia Medicaid enrollees.
• To assess the prevalence of potential inappropriate opioid prescribing indicators within this population.
• To identify specific demographic groups at higher risk for opioid-related issues.

Main Methods:

• Analysis of Georgia Medicaid pharmacy claims data from 2012.
• Comparison of opioid prescribing patterns between males and females.
• Evaluation of disparities between fee-for-service (FFS) and managed care (MC) insurance types.
• Utilized clinical guidelines and expert panels for outcome measures.
• Employed t-tests to determine statistical significance of observed disparities.

Main Results:

• Males received a higher average number of opioid prescriptions and longer days of supply than females (p<0.001).
• Fee-for-service (FFS) patients had more opioid prescriptions and longer supply durations than managed care (MC) patients (p<0.001).
• Potential inappropriate opioid prescribing indicators were significantly higher in males (1.41) versus females (0.83) (p<0.001).
• FFS patients exhibited higher rates of potential inappropriate prescribing (1.60) compared to MC patients (0.46) (p<0.001).

Conclusions:

• Statistically significant gender and insurance disparities exist in both general opioid use and potential inappropriate prescribing within Georgia Medicaid.
• Targeted policies are needed to address inappropriate opioid prescribing, particularly for male and FFS enrollees.
• These interventions aim to mitigate prescription drug abuse in this vulnerable population.