Impact of abuse-deterrent OxyContin on prescription opioid utilization.
OBJECTIVE
We quantified the degree to which the August 2010 reformulation of abuse-deterrent OxyContin affected its use, as well as the use of alternative extended-release and immediate-release opioids.


METHODS
We used the IMS Health National Prescription Audit, a nationally representative source of prescription activity in the USA, to conduct a segmented time-series analysis of the use of OxyContin and other prescription opioids. Our primary time period of interest was 12 months prior to and following August 2010. We performed model checks and sensitivity analyses, such as adjusting for marketing and promotion, using alternative lag periods, and adding extra observation points.


RESULTS
OxyContin sales were similar before and after the August 2010 reformulation, with approximately 550 000 monthly prescriptions. After adjusting for declines in the generic extended-release oxycodone market, the formulation change was associated with a reduction of approximately 18 000 OxyContin prescription sales per month (p = 0.02). This decline corresponded to a change in the annual growth rate of OxyContin use, from 4.9% prior to the reformulation to -23.8% during the year after the reformulation. There were no statistically significant changes associated with the sales of alternative extended-release (p = 0.42) or immediate-release (p = 0.70) opioids. Multiple sensitivity analyses supported these findings and their substantive interpretation.


CONCLUSIONS
The market debut of abuse-deterrent OxyContin was associated with declines in its use after accounting for the simultaneous contraction of the generic extended-release oxycodone market. Further scrutiny into the effect of abuse-deterrent formulations on medication use and health outcomes is vital given their popularity in opioid drug development.
Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Catherine S
CS
Hwang
Hsien-Yen
HY
Chang
G Caleb
GC
Alexander
D000701:Analgesics, Opioid / Q000008:administration & dosage*; D003132:Commerce; D003692:Delayed-Action Preparations; D006801:Humans; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000517:prevention & control; D010098:Oxycodone / Q000627:therapeutic use*; D055656:Prescriptions / Q000191:economics; D019966:Substance-Related Disorders / Q000517:prevention & control*; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D010098:Oxycodone
OxyContin; abuse-deterrent; drug utilization; extended-release; opioid; oxycodone; pharmacoepidemiology