Declines in opioid prescribing after a private insurer policy change - Massachusetts, 2011-2015
Open accessAbstract
implemented a comprehensive opioid utilization program after learning that many of its members were receiving new prescriptions with a >30-day supply of opioids. The 2016 CDC Guideline for Prescribing Opioids for Chronic Pain recommends avoiding opioids as a first-line therapy for chronic pain and limiting quantities when initiating opioids for acute pain (5). CDC analyzed BCBSMA prescription claims data for the period 2011-2015 to assess the effect of the new utilization program on opioid prescribing rates. During the first 3 years after policy implementation, the average monthly prescribing rate for opioids decreased almost 15%, from 34 per 1,000 members to 29. The percentage of BCBSMA members per month with current opioid prescriptions also declined. The temporal association between implementation of the program and statistically significant declines in both prescribing rates and proportion of members using opioids suggests that the BCBSMA initiative played a role in reducing the use of prescription opioids among its members. Public and private insurers in the United States could benefit from developing their own best practices for prescription opioid utilization that ensure accessible pain care, while reducing the risk for dependence and abuse associated with these drugs.
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There is good evidence that collaborative efforts with private health insurers can be successful in promoting best practices in opioid prescribing.
“There is good evidence that collaborative efforts with private health insurers can be successful in promoting best practices in opioid prescribing (192).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [192]
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Cites
CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016
Dowell, D., Haegerich, T. M., & Chou, R. (2016) · JAMA · doi:10.1001/jama.2016.1464 · Cited by 5,161 · see citing works
CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016
Dowell, D., Haegerich, T. M., & Chou, R. (2016) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr6501e1 · Cited by 2,697 · see citing works
Increases in drug and opioid overdose deaths — United States, 2000–2014
Rudd, R. A., Aleshire, N., Zibbell, J. E., & Gladden, R. M. (2016) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6450a3 · Cited by 1,859 · cited 1× · see citing works
“Overdose deaths involving opioid pain medications are epidemic in the United States, in part because of high opioid prescribing rates and associated abuse of these drugs (1).”
BackgroundMassachusetts Department of Public Health
Gallagher, S. S., Guyer, B., Kotelchuck, M., Bass, J. L., Lovejoy, F. H., McLoughlin, E., & Mehta, K. A. (1982) · New England Journal of Medicine · doi:10.1056/nejm198210143071613 · Cited by 591 · see citing works
Decline in drug overdose deaths after state policy changes - Florida, 2010-2012.
Johnson, H., Paulozzi, L. J., Porucznik, C. A., Mack, K. A., & Herter, B. (2014) · PubMed Central · Cited by 165 · see citing works
Jones, C. M., Lurie, P. G., & Throckmorton, D. C. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.7799 · Cited by 124 · see citing works
LaPensee, K. (2003) · Journal of Managed Care Pharmacy · doi:10.18553/jmcp.2003.9.1.36 · Cited by 25 · see citing works
Flagged first, then by citations
1 of the 8 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Oliva, E. M., Bowe, T. R., Manhapra, A., Kertesz, S. G., Hah, J. M., Henderson, P., Robinson, A. B., Paik, M. C., Sandbrink, F., Gordon, A. J., et al. (2020) · BMJ · doi:10.1136/bmj.m283 · Cited by 242 · see citing works
US Trends in Opioid Access Among Patients With Poor Prognosis Cancer Near the End-of-Life
Enzinger, A. C., Ghosh, K., Keating, N. L., Cutler, D., Landrum, M. B., & Wright, A. A. (2021) · Journal of Clinical Oncology · doi:10.1200/jco.21.00476 · Cited by 110 · see citing works
Patients’ Experience With Opioid Tapering: A Conceptual Model With Recommendations for Clinicians
Henry, S. G., Paterniti, D. A., Feng, B., Iosif, A., Kravitz, R. L., Weinberg, G., Cowan, P., & Verba, S. (2018) · Journal of Pain · doi:10.1016/j.jpain.2018.09.001 · Cited by 93 · see citing works
The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio
Weiner, S. G., Baker, O. N., Poon, S. J., Rodgers, A. F., Garner, C., Nelson, L. S., & Schuur, J. D. (2017) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2017.03.057 · Cited by 91 · see citing works
Evidence for state, community and systems-level prevention strategies to address the opioid crisis
Haegerich, T. M., Jones, C. M., Cote, P.-O., Robinson, A. B., & Ross, L. B. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.107563 · Cited by 89 · see citing works
Abuse-deterrent Opioid Formulations
Litman, R. S., Pagán, O. H., & Cicero, T. J. (2017) · Anesthesiology · doi:10.1097/aln.0000000000002031 · Cited by 70 · see citing works
Decline in opioid prescribing after federal rescheduling of hydrocodone products
Raji, M. A., Kuo, Y., Adhikari, D., Baillargeon, J., & Goodwin, J. S. (2017) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.4376 · Cited by 61 · see citing works
Perioperative use of opioids: Current controversies and concerns
Alexander, J. C., Patel, B. T., & Joshi, G. P. (2019) · Best practice & research. Clinical anaesthesiology · doi:10.1016/j.bpa.2019.07.009 · Cited by 59 · see citing works
A Conceptual Framework for Understanding Unintended Prolonged Opioid Use
Hooten, W. M., Brummett, C. M., Sullivan, M. D., Goesling, J., Tilburt, J. C., Merlin, J. S., Sauver, J. L. S., Wasan, A. D., Clauw, D. J., & Warner, D. O. (2017) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2017.10.010 · Cited by 55 · see citing works
A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health
Wiss, D. A. (2019) · Frontiers in Public Health · doi:10.3389/fpubh.2019.00193 · Cited by 41 · see citing works
A statewide evaluation of seven strategies to reduce opioid overdose in North Carolina
Alexandridis, A. A., McCort, A. D., Ringwalt, C. L., Sachdeva, N., Sanford, C., Marshall, S. W., Mack, K. A., & Dasgupta, N. (2017) · Injury Prevention · doi:10.1136/injuryprev-2017-042396 · Cited by 38 · see citing works
Opioid use following gynecologic and pelvic reconstructive surgery
Hota, L. S., Warda, H. A., Haviland, M. J., Searle, F. M., & Hacker, M. R. (2017) · International Urogynecology Journal · doi:10.1007/s00192-017-3474-5 · Cited by 33 · see citing works
Stein, B. D., Sherry, T. B., O’Neill, B., Taylor, E. A., & Sorbero, M. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-07119-3 · Cited by 26 · see citing works
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Ward, M. J., Diwas Singh, K. C., Jenkins, C. A., Liu, D., Padaki, A. S., & Pines, J. M. (2018) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2018.07.054 · Cited by 23 · see citing works
Medicare Formulary Coverage Restrictions for Prescription Opioids, 2006 to 2015
Samuels, E. A., Ross, J. S., & Dhruva, S. S. (2017) · Annals of Internal Medicine · doi:10.7326/m17-1823 · Cited by 22 · see citing works
Barnett, M. L., Olenski, A. R., Thygeson, N. M., Ishisaka, D. Y., Wong, S., Jena, A. B., & Mehrotra, A. (2018) · Health Affairs · doi:10.1377/hlthaff.2018.0391 · Cited by 20 · see citing works
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Mudumbai, S. C., He, H., Chen, J.-Q., Kapoor, A., Regala, S., Mariano, E. R., Stafford, R. S., Abnet, C. C., Pfeiffer, R. M., Freedman, N. D., et al. (2024) · JNCI Cancer Spectrum · doi:10.1093/jncics/pkae012 · Cited by 19 · see citing works
Maierhofer, C., Ranapurwala, S. I., DiPrete, B. L., Fulcher, N., Ringwalt, C. L., Chelminski, P. R., Ives, T. J., Dasgupta, N., Go, V. F.-L., & Pence, B. W. (2021) · Pain Medicine · doi:10.1093/pm/pnab181 · Cited by 16 · see citing works
Finley, E. P., Schneegans, S., Curtis, M. E., Bebarta, V. S., Maddry, J. K., Penney, L., McGeary, D., & Potter, J. S. (2020) · PLoS ONE · doi:10.1371/journal.pone.0234425 · Cited by 16 · see citing works
Fink, B. C., Uyttebrouck, O., & Larson, R. S. (2020) · The Journal of Law Medicine & Ethics · doi:10.1177/1073110520935336 · Cited by 14 · see citing works
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Donohoe, G., Zhang, B., Mensinger, J. L., & Litman, R. S. (2018) · Pain Medicine · doi:10.1093/pm/pny284 · Cited by 14 · see citing works
Harrison, M. L., & Walsh, T. (2019) · Clinical Toxicology · doi:10.1080/15563650.2019.1574976 · Cited by 13 · see citing works
Adejumo, A. (2021) · Annals of Gastroenterology · doi:10.20524/aog.2021.0579 · Cited by 13 · see citing works
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Enzinger, A. C., & Wright, A. A. (2020) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djaa112 · Cited by 12 · see citing works
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McCormick, C. D., Dadiomov, D., Trotzky‐Sirr, R., & Qato, D. M. (2021) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.5349 · Cited by 9 · see citing works
A statewide effort to reduce high-dose opioid prescribing through coordinated care organizations
Hartung, D. M., Alley, L., Leichtling, G. J., Korthuis, P. T., & Hildebran, C. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.04.020 · Cited by 9 · see citing works
Watson, C. J., Ganetsky, M., Burke, R. C., Dizitzer, Y., Leventhal, E. L., & Boyle, K. L. (2021) · Journal of Medical Toxicology · doi:10.1007/s13181-021-00837-4 · Cited by 9 · see citing works
Ibrahimi, S. E., Hallvik, S. E., Johnston, K. A., Leichtling, G. J., Choo, E. K., & Hartung, D. M. (2020) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.5097 · Cited by 7 · see citing works
Dun, C., Overton, H. N., Walsh, C. M., Hennayake, S., Wang, P., Fahim, C., Bicket, M. C., & Makary, M. A. (2022) · The American Surgeon · doi:10.1177/00031348221111519 · Cited by 6 · see citing works
Alexandridis, A. A., Dasgupta, N., McCort, A. D., Ringwalt, C. L., Rosamond, W. D., Chelminski, P. R., & Marshall, S. W. (2019) · Injury Epidemiology · doi:10.1186/s40621-018-0179-2 · Cited by 6 · see citing works
Association of opioid utilization management with prescribing and overdose
Andersen, M. S. (2022) · The American Journal of Managed Care · doi:10.37765/ajmc.2022.88829 · Cited by 5 · see citing works
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Sun, B., Lupulescu‐Mann, N., Charlesworth, C. J., Kim, H., Hartung, D. M., Deyo, R. A., & McConnell, K. J. (2017) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2017.10.007 · Cited by 5 · see citing works
Commercial and public payer opioid analgesic prescribing policies: a case study
Arfken, C. L., & Lehr, V. T. (2021) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/s13011-020-00340-z · Cited by 5 · see citing works
Page, J., Traver, R., Patel, S., & Saliba, C. (2018) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2018.24.3.191 · Cited by 4 · see citing works
Yenerall, J., & McPheeters, M. L. (2020) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2020.102662 · Cited by 4 · see citing works
The Effects of Medicare Advantage on Opioid Use
Baker, L. C., Bundorf, M. K., & Kessler, D. P. (2018) · National Bureau of Economic Research · doi:10.3386/w25327 · Cited by 4 · see citing works
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Barnes, M. R., Giampa, J., & Caron, M. M. (2019) · HSS Journal® The Musculoskeletal Journal of Hospital for Special Surgery · doi:10.1007/s11420-018-09666-8 · Cited by 3 · see citing works
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Auld, M. C., Horwitz, J. R., Lukenchuk, B., & McClelland, L. (2020) · Health Affairs · doi:10.1377/hlthaff.2019.01351 · Cited by 3 · see citing works
Paez, K., Lavelle, M. E., & Lin, A. (2022) · Disability and health journal · doi:10.1016/j.dhjo.2022.101294 · Cited by 2 · see citing works
Effective Reduction in Opioid Prescriptions for Ambulatory Lesion Excisions in Pediatric Patients
McKenna, R. A., Lee, A., Chen, Y., Vu, G. H., Jantzen, E. C., Brennan, P. J., Watson, A., Burlingame, C. C., & Lin, I. C. (2021) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000003466 · Cited by 2 · see citing works
Choo, E. K., Charlesworth, C. J., Livingston, C. J., Hartung, D. M., Ibrahimi, S. E., Kraynov, L., & McConnell, K. J. (2024) · Journal of General Internal Medicine · doi:10.1007/s11606-024-08776-w · Cited by 2 · see citing works
Evaluation of a Medicaid performance improvement project to reduce high-dose opioid prescriptions
Hartung, D. M., Geddes, J., Hallvik, S. E., Korthuis, P. T., Middleton, L., Leichtling, G. J., Hildebran, C., & Kim, H. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07477-6 · Cited by 1 · see citing works
Padamsee, T. J., MONTGOMERY, C., KIENZLE, S., Straughn, J. B., Elmore, A., Fulton‐Kehoe, D., Schulman, B. A., Wickizer, T. M., & Franklin, G. M. (2024) · Milbank Quarterly · doi:10.1111/1468-0009.12705 · Cited by 1 · see citing works
Emshoff, J. B., Theken, K. N., Juba, K. M., Trombetta, D. P., Denham, H., Carr, M., Love, N. C., Page, M., Uebbing, E., & Lehr, V. T. (2024) · JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · doi:10.1002/jac5.2067 · Cited by 1 · see citing works
Declines in Tapentadol Use in the US but Pronounced Regional Variation
Low, C. Y., McCall, K. L., & Piper, B. J. (2025) · Pharmacy · doi:10.3390/pharmacy13030067 · Cited by 1 · see citing works
Declines and pronounced state-level variation in tapentadol use in the USPreprint
Low, C. Y., McCall, K. L., & Piper, B. J. (2022) · medRxiv · doi:10.1101/2022.03.03.22271869
The revised CDC Chronic pain guidelines and payer opioid analgesic policies in MichiganPreprint
Lehr, V. T., & Arfken, C. L. (2023) · Research Square · doi:10.21203/rs.3.rs-3232656/v1
Hartung, D. M., Geddes, J., Hallvik, S. E., Korthuis, P. T., Middleton, L., Leichtling, G. J., Hildebran, C., & Kim, H. (2022) · Figshare · doi:10.6084/m9.figshare.18461940
Sangalli, L., Bolch, C., & Rojas‐Ramirez, M. V. (2026) · Journal of Public Health Dentistry · doi:10.1111/jphd.70039
Schneider, J. E. (2026) · Global perspectives on wealth and distribution · doi:10.1007/978-3-032-20355-7_4
- Authors
- García, M. C., Dodek, A. B., Kowalski, T., Fallon, J., Lee, S. H., Iademarco, M. F., Auerbach, J., & Bohm, M. K.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Venue
- MMWR Morbidity and Mortality Weekly Report
- Published
- 2016-10-21
- Volume
- 65
- Issue
- 41
- Pages
- 1125-1131
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- OpenAlex
- W2533477981
- Cited by
- 51
- References
- 8
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 1 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 7 · 2018: 7 · 2017: 8
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Blue Cross Blue Shield of Massachusetts
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- opioid prescribing, chronic pain, acute pain, opioid use disorder, opioid abuse, prescribing guidelines
- MeSH terms
- Analgesics, Opioid, Humans, Insurance, Health, Massachusetts, Drug Prescriptions, Program Evaluation, Organizational Policy, Private Sector
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