Changes in Prescribing by Provider Type Following a State Prescription Opioid Restriction Law

Area of Science:

• Health Services Research
• Public Health Policy
• Pharmacoeconomics

Background:

• State-level opioid prescribing regulations, including days' supply restrictions, have been enacted to curb opioid overutilization.
• Previous studies have examined these policies' impact on specific medical specialties, but a comprehensive analysis across diverse provider types is lacking.

Purpose of the Study:

• To assess the effects of Florida's opioid days' supply restriction policy on opioid utilization.
• To stratify these changes by provider type, including surgery, emergency medicine, primary care, specialty care, and dentistry.

Main Methods:

• An interrupted time series analysis was employed to evaluate opioid prescription claims data from a large private health plan in Florida.
• Provider types were categorized using Healthcare Provider Taxonomy Codes.
• Data spanned from January 1, 2015, to March 31, 2019, encompassing the policy implementation date of July 1, 2018.

Main Results:

• Significant reductions in the mean days' supply of opioid prescriptions were observed across most provider types, ranging from 14% for dentistry to 41% for specialty care.
• Emergency care and specialty care providers showed significant decreases in mean morphine milligram equivalents (MMEs) by 30% and 29%, respectively.
• Emergency care providers also experienced a 27% reduction in the mean number of units dispensed per prescription.

Conclusions:

• Opioid prescribing patterns varied significantly by provider type before the policy's implementation.
• The days' supply restriction policy demonstrated a differential impact on opioid utilization metrics (MMEs, days' supply, units dispensed) depending on the provider specialty.