Opioids in Georgia Medicaid: gender and insurance disparities in utilization and potential inappropriate prescribing practices

Objectives: Medicaid populations have been disproportionately affected by the opioid epidemic. In Georgia, opioid deaths have increased at more than twice the rate of the nation at large. It is unknown if certain populations within the Medicaid unduly receive opioid prescriptions or experience inappropriate prescribing of opioids. Thus, this study examines gender and insurance disparities in the use of opioids and the prevalence of indicators for potential inappropriate prescribing of opioids in the Georgia Medicaid population. Methods: Using individual Georgia Medicaid pharmacy claims data from 2012, disparities across gender (male/female) and type of insurance (fee-for-service (FFS)/managed care (MC)) were examined for the general use of opioids and potential inappropriate prescribing practices by providers. These outcome measures were taken from previous clinical guidelines and expert panels. T-tests were conducted to estimate significance in disparities across gender and type of insurance. Key findings: Average number of opioid prescriptions received and average days of supply of opioids were higher among men than women (P < 0.001), and among FFS patients than MC patients (P < 0.001). Similarly, average incidences of potential inappropriate prescribing of opioids were higher among men (1.41) than women (0.83) (P < 0.001), and among FFS patients (1.60) than MC patients (0.46) (P < 0.001). Conclusions: Results indicate statistically significant disparities among male/female patients and FFS/MC patients in the general use of opioids and in potential inappropriate prescribing of opioids. Policies aimed at curbing potential inappropriate prescribing of opioids, especially among male and FFS enrolees are needed to reduce prescription drug abuse within this population.