Prime identifies Identifying combination controlled substance users

What was the study about?

In today’s deadly opioid epidemic, people on opioids who also use benzodiazepines run increased risk of overdose and death. A quality metric by the Pharmacy Quality Alliance (PQA) helps identify members using both opioids and benzodiazepines. This study applied the PQA measure to a commercial population, using claims data.

What did we learn?

Using the PQA measure, 17 percent of opioid-using members had concurrent benzodiazepine use. This means that one in six opioid users, with no evidence of cancer, had concurrent opioid and benzodiazepine use for 30 or more cumulative days in 2015. 

Methods

The study used 2015 claims data from approximately 15 million commercial members to identify members with one or more opioid and benzodiazepine claims. Integrated medical data was used to exclude members with a cancer diagnosis code. Opioid claims in the analysis excluded cough and cold medicine, injectable formulations, or buprenorphine products used to treat opioid use disorder.

Results

Using the PQA industry measures, the study found that one in six opioid users is also using a benzodiazepine. This puts them at higher risk for respiratory depression that can lead to death. This is an alarming number of members at risk. 

Conclusions

Quality of care will be assessed by rate of combination use in plan sponsor membership. Prime suggests identifying at risk members and developing clinical programs to address combination use.

What does this mean for you?

Prime’s Controlled Substance (CS) Management Program can help plan sponsors identify members at high risk for many different strata of controlled substance abuse, including combination use. The program uses many kinds of measures, based on plan sponsors’ needs. Then plan sponsors can select from a range of programs to help reduce CS abuse – improving safety and improving health outcomes. Plan sponsors may want to work with Prime to intervene through the GuidedHealth program.