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The American Journal of Managed Care May 2017
Drivers of Excess Costs of Opioid Abuse Among a Commercially Insured Population
Lauren M. Scarpati, PhD; Noam Y. Kirson, PhD; Miriam L. Zichlin, MPH; Zitong B. Jia, BA; Howard G. Birnbaum, PhD; and Jaren C. Howard, PharmD
Critical Incident Stress Debriefing After Adverse Patient Safety Events
Reema Harrison, PhD, MSc, BSc, and Albert Wu, MD, MPH
Assessing the Effect of the VHA PCMH Model on Utilization Patterns Among Veterans With PTSD
Ian Randall, PhD; Charles Maynard, PhD; Gary Chan, PhD; Beth Devine, PhD; and Chris Johnson, PhD
State Prescription Drug Monitoring Programs and Fatal Drug Overdoses
Young Hee Nam, PhD; Dennis G. Shea, PhD; Yunfeng Shi, PhD; and John R. Moran, PhD
Disparities in Diabetes and Hypertension Care for Individuals With Serious Mental Illness
Junqing Liu, PhD; Jonathan Brown, PhD; Suzanne Morton, MPH; D.E.B. Potter, MS; Lisa Patton, PhD; Milesh Patel, MS; Rita Lewis, MPH; and Sarah Hudson Scholle, DrPH
The Cost of Adherence Mismeasurement in Serious Mental Illness: A Claims-Based Analysis
Jason Shafrin, PhD; Felicia Forma, BSc; Ethan Scherer, PhD; Ainslie Hatch, PhD; Edward Vytlacil, PhD; and Darius Lakdawalla, PhD
Prescription Opioid Registry Protocol in an Integrated Health System
G. Thomas Ray, MBA; Amber L. Bahorik, PhD; Paul C. VanVeldhuisen, PhD; Constance M. Weisner, DrPH, MSW; Andrea L. Rubinstein, MD; and Cynthia I. Campbell, PhD, MPH
Opioid Prescribing for Chronic Pain in a Community-Based Healthcare System
Robert J. Romanelli, PhD; Laurence I. Ikeda, MD; Braden Lynch, PharmD; Terri Craig, PharmD; Joseph C. Cappelleri, PhD; Trevor Jukes, MS; and Denis Y. Ishisaka, PharmD
The Association of Mental Health Program Characteristics and Patient Satisfaction
Austin B. Frakt, PhD; Jodie Trafton, PhD; and Steven D. Pizer, PhD
Currently Reading
Medicaid Prior Authorization and Opioid Medication Abuse and Overdose
Gerald Cochran, PhD; Adam J. Gordon, MD, MPH; Walid F. Gellad, MD, MPH; Chung-Chou H. Chang, PhD; Wei-Hsuan Lo-Ciganic, PhD, MS, MSPharm; Carroline Lobo, MS; Evan Cole, PhD; Winfred Frazier, MD; Ping

Medicaid Prior Authorization and Opioid Medication Abuse and Overdose

Gerald Cochran, PhD; Adam J. Gordon, MD, MPH; Walid F. Gellad, MD, MPH; Chung-Chou H. Chang, PhD; Wei-Hsuan Lo-Ciganic, PhD, MS, MSPharm; Carroline Lobo, MS; Evan Cole, PhD; Winfred Frazier, MD; Ping
Enrollees in Medicaid plans employing prior authorization policies for opioid medications may have lower rates of opioid medication abuse and overdose.
This study examined associations between PA requirements and developing abuse or experiencing an opioid medication overdose following an index opioid medication fill for Medicaid enrollees. These findings extend previous research by demonstrating improved outcomes among patients within PA plans in terms of lower rates of abuse and overdose. Future research should seek to extend these findings within more rigorous causal designs/analyses and among other Medicaid and commercial payer data to continue building evidence for PA policies reducing problematic opioid behaviors and consequences. 

Author Affiliations: School of Social Work (GC), and School of Medicine (C-CHC), Department of Psychiatry (GC), and School of Medicine, Division of General Internal Medicine (AJG, WFG, WF), and Center for Pharmaceutical Policy and Prescribing (GC, AJG, WFG, JMD), and Graduate School of Public Health (C-CHC, CL, EC, PZ, JMD), University of Pittsburgh, Pittsburgh, PA; VA Pittsburgh Healthcare System (AJG, WFG), Pittsburgh, PA; University of Arizona, College of Pharmacy (WL-C), Tucson, AZ; Pennsylvania Department of Human Services, Medical Assistance Programs (DK), PA.

Source of Funding: Centers for Disease Control and Prevention (U01CE002496).

Author Disclosures: Dr Gordon has received grants from NIH, VA, and other public grants; the contents do not represent views of the US department of Veterans Affairs or the US government. The remaining authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (GC, AJG, WFG, WF, DK, JMD); acquisition of data (GC, PZ, JMD); analysis and interpretation of data (GC, AJG, WFG, WL-C, DK, CL, EC, WF, PZ, JMD); drafting of the manuscript (GC, AJG, C-CHC, WL-C, CL, JMD); critical revision of the manuscript for important intellectual content (GC, AJG, WFG, WL-C, CL, EC, WF, DK, JMD); statistical analysis (GC, C-CHC, WL-C, PZ); obtaining funding (GC, JMD); administrative, technical, or logistic support (EC, JMD); and supervision (JMD).

Address Correspondence to: Gerald Cochran, PhD, University of Pittsburgh, 4200 Forbes Ave, 2117 CL, Pittsburgh, PA 15260. E-mail: 

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