OBJECTIVES: Efforts to curtail the over-prescription of opioids in the US have included legislation to enhance prescription drug monitoring programs and regulation of pain clinics, along with an increase in physician training programs focused on improved prescribing practices. The purpose of this study was to examine real world evidence of opioid prescribing trends over the past decade among newly diagnosed chronic pain (CP) patients.

METHODS: This retrospective analysis utilized the IBM^® MarketScan^® Research Database spanning 2012-2017. Annual samples of adults with continuous enrollment for two years (the index year and prior year) were identified. All patients were required to present two medical claims with a diagnosis for low back pain, osteoarthritis, fibromyalgia, diabetic peripheral neuropathy, or chronic pain during the index year, and must have presented an absence of pain diagnoses and opioid prescriptions during the preceding year. Opioid and non-opioid analgesic use and total healthcare expenditure was assessed.

RESULTS: From 2012 to 2017, there was a 17.2% decrease in the proportion of CP patients prescribed opioids (40.6% to 33.6%). The mean days’ supply of opioids per prescription decreased (-13.0%; 8.85 days to 7.70 days), as did the total number of opioid fills (-17.4%; 2.59±2.82 to 2.14±2.20), and total days’ supply (-25.3%; 27.9±49.5 to 20.8±40.7). There was a slight increase in the prescription of non-opioid analgesics over the study period (6.1%; 40.2% to 42.6%), and a 37.1% decrease in the proportion of patients with annual supplies of opioids > 90 days (7.1% to 4.4%). Total healthcare costs increased 8.4% ($15,304±$34,950 to $16,333±$41,599).

CONCLUSIONS: Opioid prescriptions have been decreasing over the past decade among CP patients. This trend included a decline in extended use (> 90 days), and did not result in notable increases in healthcare costs. Though work is still needed, results demonstrate measurable progress in the ongoing opioid epidemic.