Prescription Fill Rates and Length of Dosage Remain a Concern

A new report from the Center for Improving Value in Health Care (CIVHC), based on data in the Colorado All Payer Claims Database (CO APCD), helps isolate opportunities to reduce opioid use disorders in the state.  While some common opioids are being filled less, the number of days supply being prescribed is often outside recommended guidelines, increasing the potential for addiction.

One critical approach to the multiple ways to address the opioid epidemic is to minimize the number of pills given to people with temporary, acute pain. Centers for Disease Control (CDC) research indicates that prescribing a longer duration dosage can significantly increase a person’s chance of becoming addicted. Therefore, the CDC suggests that providers offer alternative treatment options to opioids, and when necessary, prescribe the lowest effective dose for the shortest duration, typically three to seven days.

CO APCD data from 2009-2017 for short-acting versions of three commonly prescribed opioids – Oxycodone, Percocet, and Vicodin – indicates that prescribing often falls outside of CDC minimum necessary recommendations.

More than half of all prescriptions for the three medications were for eight days or more and therefore outside of the CDC recommended guidelines. Oxycodone had higher rates of 15-30 days supply compared to 1-7 or 8-14 days, and 69 percent of all Oxycodone fills were for eight days or more.

According to the analysis, both Percocet and Vicodin fill rates have fallen since 2014, yet overall since 2009, Percocet fill rates have increased nearly 36 percent. In spite of being the least prescribed medication of the three in 2017, Oxycodone fill rates have more than tripled since 2009.

“It is encouraging to see opioids being prescribed less in some instances, but this data confirms there is more we can do as a state to reduce the sheer number of prescriptions and length of supply of opioids,” stated Ana English, CIVHC President and CEO.

There are multiple ways to address the opioid prescribing patterns highlighted in this analysis including:

  • Continued provider education on recommended prescribing practices
  • Patient education on the addictive properties of opioids
  • More research and widespread acceptance of alternative pain management choices

Colorado has been addressing some of these solutions through a number of avenues including proposing legislation for treatment and recovery, Medicaid restrictions for opioid prescribing, the Colorado Hospital Association’s Colorado Opioid Safety Pilot, and recommendations and education from the Colorado Consortium for Prescription Drug Abuse Prevention.

“Similar to the complexity of solving health care in general, addressing the opioid crisis is going to take a concerted, multi-pronged approach with multiple stakeholders and community engagement across the state,” explained English. “This analysis helps illuminates some of the key opportunities facing our state, and we look forward to tracking progress as we start to address these issues.”

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