An Evaluation of Prescription Drug Monitoring Programs

Abstract

This research examines the effects of Prescription Drug Monitoring Programs (PDMPs) on the supply and abuse of prescription drugs. Information from the Automation of Reports and Consolidated Orders System (ARCOS) is used to develop measures of supply, and information from the Treatment Episode Data Set (TEDS) is used to develop measures of abuse. Practical considerations lead us to focus on Schedule II pain relievers and stimulants, and composite measures for these two classes of drugs are developed. We estimate both aggregate and individual response models. The aggregate model suggests that PDMPs reduce the per capita supply of prescription pain relievers and stimulants and in so doing reduce the probability of abuse for these drugs. The evidence also suggests that states which are proactive in their approach to regulation are more effective in reducing the per capita supply of prescription pain relievers and stimulants than states which are reactive in their approach to regulation. The individual response model confirms these findings. It is important to note that the probability of pain reliever abuse is actually higher in states that have PDMPs than in states that do not. But our analysis demonstrates that in the absence of such programs the probability of abuse would be higher still.

Windmills and Pill Mills: Can PDMPs Tilt the Prescription Drug Epidemic?

“…Although data regarding the overall effects of PDMPs is limited, current evidence appears to indicate benefits for both law enforcement and health care. In 2006, the US Department of Justice sponsored an independent evaluation of PDMPs, which tracked Schedule II medication supply and abuse using statistical modeling and two databases: the Automation of Reports and Consolidated Orders System (ARCOS) and the Treatment Episode Data Set [20]. The report found that PDMPs reduce the per capita supply of prescription opioids and thus reduce the probability for abuse, a finding that the study's authors confirmed with a model estimating individual-level response.…”

“…Under appropriate circumstances, these programs generate unsolicited reports that are sent to the relevant prescribers. The threshold for activation of an unsolicited report also varies from state to state; for example, New York generates an automatic report if an individual has filled prescriptions for Scheduled substances at two or more pharmacies within the previous month [20]. PDMP reports may be sent to prescribers, pharmacies, law enforcement, or other entities, depending on state law.…”

Attitudes of Florida Pharmacists Toward Implementing a State Prescription Drug Monitoring Program for Controlled Substances

“…The PDMPs were found to deter "doctor shopping," but diversion increased in the bordering states that did not implement a PDMP. 27 Simeone and Holland (2006) found that states with PDMPs, especially those with proactive programs, had lower rates of supply of schedule II pain relievers and stimulant drugs compared with states that did not have PDMPs. 31 …”

“…16 Evidence suggests that PDMPs may serve as a tool to prevent and detect prescription drug abuse and diversion. [23][24][25][26][27][28][29][30][31][32] However, the efficacy and utility of PDMPs throughout the United States have not been thoroughly analyzed. Curtis et al measured the period prevalence of claims for opioid analgesics and controlledrelease oxycodone at the county level in 2000, finding that a statewide schedule II PDMP, along with the proportions of the population aged 15 to 24 years and aged 65 years or older, were associated with opioid lower claim rates.…”

Review of Regulatory Programs and New Opioid Technologies in Chronic Pain Management: Balancing the Risk of Medication Abuse with Medical Need

“…As a reactive system, information about a potential abuser is produced only following an inquiry made by a prescriber or managed care organization. 77 In proactive systems, state program personnel regularly review records to identify any suspicious activities and generate unsolicited reports that are then forwarded to physicians, pharmacists, and regulatory agencies in an effort to reduce diversion before it occurs (e.g., before a prescription is filled at a pharmacy). 77 A 2006 survey the euphoric effects of the opioid.…”