Low-value Care

Disappointing Early Results From Opioid Prescribing Limits for Acute Pain

Abstract: Between 2016 and 2019, the United States experienced a rapid proliferation of limits restricting the duration or number of doses in opioid prescriptions for acute pain.1 As of October 2019, such limits have been enacted by 34 states; large payers, such as Medicare, several state Medicaid programs, Aetna, and UnitedHealth; pharmacy chains, such as Sam’s Club/Walmart; and major pharmacy benefit managers, such as CVS CareMark, ExpressScripts, and OptumRx, which collectively manage drug benefits for 180 million Americans.

Publication: JAMA Surgery

Date Published: May 11, 2020

Author(s): Kao-Ping Chua, MD, PhD, Lauren Kimmel, BS, and Chad M. Brummett, MD

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To eliminate medication overload, serious cultural, educational, and policy changes are needed. This action plan offers recommendations for policymakers, health care institutions, clinicians, and patients across five key categories to reduce harm from multiple medication use. Suggested Citation: Eliminating medication overload: A national action plan. Working Group on Medication Overload. Brookline, MA: The Lown Institute, 2020. DOI: https://doi.org/10.46241/LI.YLBW4885

Pharmaceutical marketing is a significant factor in the growing public health crisis of medication overload, which puts millions of older adults at risk of preventable harm and premature death. This issue brief provides recommendations to reduce pharmaceutical industry influence by limiting pharma sales rep visits to clinicians and direct-to-consumer advertising.

This issue brief provides recommendations for clinical practice guidelines and electronic health records that would give clinicians the information they need to appropriately prescribe and deprescribe.