Mandatory use of prescription drug monitoring program and benzodiazepine prescribing among U.S. Medicaid enrollees

Abstract

Background

In the past two decades, the U.S. saw an alarmingly increasing trend of benzodiazepine prescribing. Mandatory use of Prescription Drug Monitoring Programs (PDMPs) was suggested to have the potential to reduce opioid prescribing, but little is known about its impacts on benzodiazepines. This study examined whether PDMP data use mandates were associated with changes in benzodiazepine prescribing in the U.S. Methods: Aggregate state quarterly prescription drug records of benzodiazepines for Medicaid enrollees during 2010–2017 were obtained from the U.S. Medicaid State Drug Utilization Data. Three population-adjusted outcome variables were evaluated, including quantity, dosage, and Medicaid spending of benzodiazepine prescriptions per quarter per 100 Medicaid enrollees. The primary policy variable was the state-wide implementation of PDMP data use mandates for benzodiazepines. To account for between-state variations in mandates, an additional policy variable was considered to indicate strong mandates on PDMP data use, which required all prescribers to query a patient’s PDMP records for first prescribing and subsequent prescribing at least every 12 months. Linear regressions with difference-in-difference approach were used to assess the associations between PDMP data use mandates and benzodiazepine prescribing, controlling for state-level time-varying policy and socioeconomic covariates. Results: The state-wide implementation of PDMP data use mandates for benzodiazepines was not associated with quantity, dosage, or Medicaid spending of benzodiazepine prescriptions. Strong mandates on PDMP data use were not associated with any benzodiazepine prescribing outcomes, either. Conclusions: There was no evidence for the associations between PDMP data use mandates for benzodiazepines and changes in benzodiazepine prescribing among Medicaid enrollees. Future research is warranted to replicate the study in other populations using individual patient records and continuously monitor the trends in benzodiazepine prescribing in association with PDMPs.

Keywords:

• Prescription drug monitoring program
• benzodiazepines
• Medicaid

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

Funding acquisition: Y. S. Study conceptualization and design: D. L. and Y. S. Statistical analyses: D. L., H. G., and Y. S. Finding interpretation, manuscript writing, and critical revision: D. L., H. G., and Y. S.Final approval of the submitted manuscript: D. L., H. G., and Y. S.

Additional information

Funding

This research was supported by grant R01DA042290 (PI: Yuyan Shi) from the U.S. National Institute on Drug Abuse. The U.S. National Institute on Drug Abuse had no role in the study design, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.