Consequences of the 1989 New York State triplicate benzodiazepine prescription regulations.
OBJECTIVE
Comparison of psychoactive medication prescribing and Medicaid expenditures before (1987 through 1988) and after (1989 through 1990) institution of the New York State triplicate benzodiazepine regulations.


METHODS
The National Prescription Audit (IMS America, Plymouth Meeting, Pa), New York State Medicaid, and Blue Cross/Blue Shield fo the Rochester (NY) Area.


RESULTS
From 1988 to 1989, New York State benzodiazepine prescribing decreased by 44%, 60%, and 30% as assessed by IMS America, Medicaid, and Blue Cross/Blue Shield, respectively. Prescribing of the following alternative sedative-hypnotics increased in New York State compared with decreases nationally (IMS America data): meprobamate, +125% vs -9%; methyprylon, +84% vs -15%; ethchlorvynol, +29% vs -18%; butabarbital, +31% vs -15%; hydroxyzine, +15% vs -1.1%; and chloralhydrate, +136% vs -0.4%. Increased prescribing of alternatives was also seen in the Medicaid and Blue Cross/Blue Shield data. Medicaid benzodiazepine expenditures decreased 52% from 1988 to 1989 ($21.7 million to $10.4 million). Alternative sedative expenditures increased 115% ($3.9 million to $8.4 million). Total Medicaid psychoactive medication expenditures remained nearly constant ($46.7 million to $45.6 million).


CONCLUSIONS
Although the triplicate regulations have decreased benzodiazepine prescribing, an undesirable increase has occurred in the prescribing of less acceptable medications. The wider public health, patient care, and financial implications of triplicate benzodiazepine regulations are of concern and require further study before other jurisdictions undertake similar programs.
Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, NY 14642.
M
M
Weintraub
S
S
Singh
L
L
Byrne
K
K
Maharaj
L
L
Guttmacher
D014151:Anti-Anxiety Agents / Q000191:economics / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000191:economics; D001569:Benzodiazepines; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D008484:Medicaid / Q000706:statistics & numerical data; D009518:New York; D017063:Outcome Assessment, Health Care; D011635:Public Health Administration / Q000331:legislation & jurisprudence*; D014149:Tranquilizing Agents / Q000191:economics; D014481:United States
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014149:Tranquilizing Agents; D001569:Benzodiazepines