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Double Threat: Analysis of Opioid and Benzodiazepine Discontinuation Rates After a Pharmacy Benefit Manager Mailing to Prescribers in Commercial Clients

by NgocThanh Nguyen, PharmD, Marleen Wickizer, PharmD, AE-C, CDCES, Agata Siwak, PharmD, Maria Hurst, PMC, Nicole Dahlke, Robert Topp PhD, RN 

Objective: To determine the effect of prescriber mailings on the discontinuation of opioids and/or benzodiazepines among commercial health plan members who are prescribed these medications concurrently.
Methods: A retrospective analysis was conducted on members of two commercial health plans who had concurrent claims for both opioids and benzodiazepines for two of four months between March and June of 2019. Letters were mailed to the prescribers of members of one commercial health plan; this was the intervention group. The primary endpoint was the percentage of members with discontinuation of one or more opioids and/or benzodiazepines after the intervention. Secondary endpoints included morphine milligram equivalent (MME) for opioids, number of prescriptions, day supply, and quantity in each class.
Results: A higher percentage of the intervention group (52.8%) discontinued an opioid and/or benzodiazepine compared to the control group (41.4%). However, this difference was not statistically significant (p=0.09). Over the duration of the study, the intervention group experienced a significant decline (p<0.05) in all metrics of opioid prescriptions. This included the change in average MME compared to the control group (-10.5 vs. – 4.1, p<0.05). The intervention group significantly declined in all metrics of benzodiazepine prescriptions over the duration of the study compared to baseline and the control group.
Conclusion: Following prescriber mailings, opioid and benzodiazepine prescriptions were reduced among members concurrently prescribed these medications. 


Keywords: Benzodiazepines Analgesics, Opioid, Touch, Judgment, Practice Patterns, Physicians, Antidepressive Agents, Electronics, Centers for Disease Control and Prevention, U.S.

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  • Home
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