Trends in the use and abuse of branded and generic extended release oxycodone and fentanyl products in the United States

Theodore J. Cicero, James A. Inciardi, Hilary Surratt

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Background: A great deal of previous work on the pharmacoeconomics of alcohol, tobacco and illicit drug abuse indicates that as cost decreases, abuse increases and vice versa. The application of these cost principles to the abuse of prescribed medications is largely unknown. In this paper we assessed whether the introduction of generic products in the U.S. increased the therapeutic use and illicit abuse of extended release oxycodone products and the fentanyl patch. Methods: As an index of therapeutic use, we purchased prescription data for each of the ZIP codes in which we had corresponding abuse data. To gather information about prescription drug abuse, we elicited cases with quarterly questionnaires completed by a key informant network. Results: The introduction of generic extended release (ER) oxycodone and fentanyl patch did not significantly change the total prescriptions written for these products, but markedly altered the composition of sales: branded sales dropped precipitously over a very short time and this was compensated for by a corresponding increase in sales of generics. Surprisingly, the introduction of generic products did not increase the abuse of ER oxycodone or fentanyl products; the branded version was the drug of choice for at least 2 years. Conclusions: Our data suggest that drug costs alone do not increase the overall likelihood that a prescription opioid analgesic will be used therapeutically or abused. However, while generics are rapidly endorsed by insurance companies as a prescribed entity, abuse of the branded versions of ER oxycodone and fentanyl remains predominant for some time.

Original languageEnglish
Pages (from-to)115-120
Number of pages6
JournalDrug and Alcohol Dependence
Issue number2-3
StatePublished - Dec 1 2007

Bibliographical note

Funding Information:
This research was supported by a grant from Denver Health and Hospital Authority, under the auspices of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS ® ) program. This program is in turn funded by pharmaceutical subscribers (Purdue Pharma, Inc., Cephalon and PriCara) who pay fees to obtain information on these products. The data are, however, owned by the participating academic centers and access is granted only by quarterly reports to each subscriber. The authors have multiple consulting relationships with pharmaceutical companies, none of which would seem to have any financial interest in the results of our studies.


  • Fentanyl
  • Generics
  • Opioids
  • Oxycodone
  • Pharmacoeconomics
  • Prescription drug abuse

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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