Research Roundup: Laws To Curb Opioids; Cancer Spending; Special Enrollment Periods
Each week, KHN compiles a selection of recently released health policy studies and briefs.
The New England Journal of Medicine:
State Legal Restrictions And Prescription-Opioid Use Among Disabled Adults
We tested associations between prescription-opioid receipt and state controlled-substances laws [using Medicare administrative data for fee-for-service disabled beneficiaries] .,.. From 2006 through 2012, states added 81 controlled-substance laws. Opioid receipt and potentially hazardous prescription patterns were common. In 2012 alone, 47% of beneficiaries filled opioid prescriptions (25% in one to three calendar quarters and 22% in every calendar quarter); 8% had four or more opioid prescribers; 5% had prescriptions yielding a daily MED of more than 120 mg in any calendar quarter; and 0.3% were treated for a nonfatal prescription-opioid overdose. ... Adoption of controlled-substance laws was not associated with reductions in potentially hazardous use of opioids or overdose among disabled Medicare beneficiaries, a population particularly at risk. (Meara et al., 6/22)
Health Affairs:
Implementation Of Prescription Drug Monitoring Programs Associated With Reductions In Opioid-Related Death Rates
[F]orty-nine states (all but Missouri) created prescription drug monitoring programs to detect high-risk prescribing and patient behaviors. ... In adjusted analyses we found that a state’s implementation of a program was associated with an average reduction of 1.12 opioid-related overdose deaths per 100,000 population in the year after implementation. Additionally, states whose programs had robust characteristics—including monitoring greater numbers of drugs with abuse potential and updating their data at least weekly—had greater reductions in deaths, compared to states whose programs did not have these characteristics. (Patrick et al., 6/22)
JAMA/The Kaiser Family Foundation:
A Snapshot of Cancer Spending and Outcomes
This Visualizing Health Policy infographic provides details on cancer spending and outcomes in the United States. The U.S. cancer mortality rate, 203 deaths per 100,000 population, was slightly lower than in comparable countries in 2010. Among cancers, lung cancer is the largest contributor to disease burden for both men and women. The United States spent $124 billion to treat cancer in 2012, which accounted for about 7% of the nation’s disease-based health expenditures. However, growth in cancer spending contributed only 6.3% to the nation’s medical services expenditure growth, while the top 3 diseases contributed 36%. ... Cancer medications were among the top 3 for specialty drug spending in 2015, behind medications for inflammatory conditions and multiple sclerosis. (Gonzalez et al., 6/21)
Morbidity and Mortality Weekly Report (MMWR):
State And Local Comprehensive Smoke-Free Laws For Worksites, Restaurants, And Bars — United States, 2015
The number of states, including the District of Columbia (DC), with comprehensive smoke-free laws (statutes that prohibit smoking in indoor areas of worksites, restaurants, and bars) increased from zero in 2000 to 26 in 2010 and 27 in 2015. The percentage of the U.S. population that is protected increased from 2.72% in 2000 to 47.8% in 2010 and 49.6% in 2015. Regional disparities remain in the proportions of state populations covered by state or local comprehensive smoke-free policies, as no state in the southeast has a state comprehensive law. In addition, nine of the 24 states that lack state comprehensive smoke-free laws also lack any local comprehensive smoke-free laws. (Tynan et al., 6/24)
Urban Institute:
Helping Special Enrollment Periods Work Under The Affordable Care Act
On June 17, 2016, CMS began requiring consumers to document eligibility for special enrollment periods (SEPs). Some evidence suggests the need for verification. However, requesting documentation is likely to reduce enrollment by eligible people, given past experience with similar policies. It may be more effective to seek consumer documentation only if the Marketplace cannot quickly verify eligibility with existing data systems or phone calls. Roughly 5% of the SEP-eligible uninsured enrolled in 2015. Vigorous marketing by carriers and brokers might greatly increase SEP participation. However, such marketing will not happen if insurers continue seeing SEP members as financially untenable. (Dorn, 6/23)
Here is a selection of news coverage of other recent research:
Reuters:
Price, Stigma May Keep Patients From Using Insurance For STDs
Barriers to getting tested or treated for sexually transmitted disease (STD) need to be lowered, a U.S. study concludes. In 2013, before the Affordable Care Act -- better known as Obamacare -- was fully implemented, researchers found that half of patients at STD clinics were unwilling to use their health insurance for their visits, mainly because they worried about privacy or cost. (Doyle, 6/17)
Reuters:
Many Surgical Readmissions Can't Be Blamed On Hospitals
When too many surgery patients come back to a hospital after being sent home, the hospital can be fined by the federal government. But a new study suggests many of those so-called readmissions are not the hospital's fault. Many readmissions were due to issues like drug abuse or homelessness, the researchers found. (Seaman, 6/20)
Reuters:
Many Patients At Risk For Stroke Get Wrong Medicine
More than a third of patients with a heart rhythm problem that can cause a stroke are incorrectly given aspirin instead of the blood-thinning medications they need to make this complication less likely, a U.S. study suggests. (Rapaport, 6/20)