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. 2021 Oct;26(10):e1890-e1892.
doi: 10.1002/onco.13898. Epub 2021 Jul 21.

Prescription Opioids Dispensed to Patients with Cancer with Bone Metastasis: 2011-2017

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Prescription Opioids Dispensed to Patients with Cancer with Bone Metastasis: 2011-2017

Hao Zhang et al. Oncologist. 2021 Oct.

Abstract

Opioid therapy is a first-line approach for moderate-to-severe pain associated with cancer with bone metastasis (CBM). The decade-long decline in opioid prescribing in the U.S. would not be expected to affect patients with CBM. We investigated trends in opioids dispensed to patients with CBM using data from a large commercial claims database. From 2011 quarter 2 to 2017 quarter 4, the percentage of patients with CBM prescribed at least 1 day of opioids in a quarter declined from 28.1% to 24.5% (p < .001) for privately insured patients aged 18-64 years and from 39.1% to 30.5% (p < .001) for Medicare Advantage (MA) patients aged 65 years or older. Among patients with at least 1 day of opioids in a quarter, the average morphine milligram equivalents dispensed declined by 37% and 11% (p < .001 for both) for privately insured and MA patients, respectively. Our findings raise concerns about potential unintended consequences related to population-level reduction in opioid prescribing.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Figures

Figure 1
Figure 1
Percentage of patients with cancer with bone metastasis who had at least 1 day of prescription opioids in a calendar quarter: Q2 of 2011 to Q4 of 2017. Vertical dashed line represents Q1 of 2016, when the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain was published. Abbreviations: CDC, Centers for Disease Control and Prevention; Q, quarter.
Figure 2
Figure 2
Average total MMEs dispensed to patients with cancer with bone metastasis with at least 1 day of prescription opioids in a quarter: Q2 of 2011 to Q4 of 2017. Vertical dashed line represents Q1 of 2016, when the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain was published. Abbreviations: CDC, Centers for Disease Control and Prevention; MME, morphine milligram equivalent; Q, quarter.

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