- A new report on opioids from DC-based healthcare consulting firm Avalere found supply levels were 11% lower in 2017 compared with 2016.
- The decline is seen in most states, and the greatest reductions are where laws have been passed to set limits on opioid prescriptions, with Maine seeing a fall of 24.8% after legislation was passed in 2016.
- The only state to see an increase was Idaho, with a 59.7% growth in opioid prescriptions. This included an almost three-fold rise between 2016 and 2017 in the amount of oxycodone sold.
Avalere's analysis is based on opioid analgesics data from the Drug Enforcement Agency's Automation of Reports and Consolidated Orders System, which tracks distribution of most controlled substances from manufacture through distribution and point-of-sale.
In analyzing the data, the consultancy excluded buprenorphine and methadone as the drugs are used to treat opioid use disorder. Alfentanil and remifentanil were also excluded because data was not available for those drugs in 2016.
During 2016, Connecticut, Maine, Massachusetts, New York, Pennsylvania, Rhode Island and Vermont all passed laws limiting opioid prescriptions to between three and 14 days, or limiting the morphine milligram equivalent (MME) amount of medication that can be prescribed. The number of states with legislation in place has now risen to 22.
The DEA is also playing its part by tightening the management of the manufacture of opioids, including taking drug abuse into account when setting annual production limits.
A hiccup from data vendor IQVIA may cause an issue in estimating drug use, however. The FDA gets data on certain opioids from the IQVIA National Sales Perspectives database. After an analysis, the FDA found that the IQVIA database had previously been overestimating the total amount of fentanyl distributed in kilograms by around 20%. This resulted from use of the wrong weight-based conversion factors to determine the amount of fentanyl in a given unit (such as a single fentanyl patch) for a subset of prescription fentanyl products.
FDA analysts are looking through IQVIA data to see if there are any other errors, and have found additional data quality issues related to several other controlled substances, including oxymorphone and hydrocodone.
FDA Commissioner Scott Gottlieb has called on IQVIA to use an independent auditor to carry out a complete review of the data quality and quality control of the IQVIA products used by the FDA, and to provide more transparency on the methods IQVIA uses to generate its data.