{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T08:16:04Z","timestamp":1792743364433,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T00:00:00Z","timestamp":1500422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Centers for Disease Control and Prevention in Atlanta","award":["1U011CE002500"],"award-info":[{"award-number":["1U011CE002500"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Out\u2010of\u2010pocket payment for prescription opioids is believed to be an indicator of abuse or diversion, but few studies describe its epidemiology. Prescription drug monitoring programs (PDMPs) collect controlled substance prescription fill data regardless of payment source and thus can be used to study this phenomenon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the frequency and characteristics of prescription fills for opioids that are likely paid out\u2010of\u2010pocket by individuals in the Oregon Medicaid program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Research Design<\/jats:title><jats:p>Cross\u2010sectional analysis using Oregon Medicaid administrative claims and PDMP data (2012 to 2013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Continuously enrolled nondually eligible Medicaid beneficiaries who could be linked to the PDMP with two opioid fills covered by Oregon Medicaid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measures<\/jats:title><jats:p>Patient characteristics and fill characteristics for opioid fills that lacked a Medicaid pharmacy claim. Fill characteristics included opioid name, type, and association with indicators of high\u2010risk opioid use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 33\u00a0592 Medicaid beneficiaries filled a total of 555\u00a0103 opioid prescriptions. Of these opioid fills, 74\u00a0953 (13.5%) could not be matched to a Medicaid claim. Hydromorphone (30%), fentanyl (18%), and methadone (15%) were the most likely to lack a matching claim. The 3 largest predictors for missing claims were opioid fills that overlapped with other opioids (adjusted odds ratio [aOR] 1.37; 95% confidence interval [CI], 1.34\u20101.4), long\u2010acting opioids (aOR 1.52; 95% CI, 1.47\u20101.57), and fills at multiple pharmacies (aOR 1.45; 95% CI, 1.39\u20101.52).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prescription opioid fills that were likely paid out\u2010of\u2010pocket were common and associated with several known indicators of high\u2010risk opioid use.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4254","type":"journal-article","created":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T11:55:16Z","timestamp":1500465316000},"page":"1053-1060","source":"Crossref","is-referenced-by-count":24,"title":["Using prescription monitoring program data to characterize out\u2010of\u2010pocket payments for opioid prescriptions in a state Medicaid program"],"prefix":"10.1002","volume":"26","author":[{"given":"Daniel M.","family":"Hartung","sequence":"first","affiliation":[{"name":"Oregon State University\/Oregon Health &amp; Science University  Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharia M.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Oregon State University\/Oregon Health &amp; Science University  Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Middleton","sequence":"additional","affiliation":[{"name":"Oregon State University\/Oregon Health &amp; Science University  Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Van Otterloo","sequence":"additional","affiliation":[{"name":"Oregon Public Health Division  Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Zhang","sequence":"additional","affiliation":[{"name":"US Centers for Disease Control and Prevention  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shellie","family":"Keast","sequence":"additional","affiliation":[{"name":"University of Oklahoma College of Pharmacy  Oklahoma City OK USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunjee","family":"Kim","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Science University  Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4292-7061","authenticated-orcid":false,"given":"Kirbee","family":"Johnston","sequence":"additional","affiliation":[{"name":"Oregon State University\/Oregon Health &amp; Science University  Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Deyo","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Science University  Portland OR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1496"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1673"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0448"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4039"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0355"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0091270012436561"},{"key":"e_1_2_9_8_1","unstructured":"Using PDMPs to improve medical care: Washington State's data sharing initiative with Medicaid and workers' compensation.Prescription Drug Monitoring Program Center of Excellence at Brandeis University;2013."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000245"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.01.475"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2014\/17\/E119"},{"key":"e_1_2_9_12_1","unstructured":"Stakeholders' challenges and red flag warning signs related to prescribing and dispensing controlled substances national association of boards of pharmacy; March 20152015."},{"key":"e_1_2_9_13_1","unstructured":"Pharmacists: on the front lines addressing prescription opioid abuse and overdose.2016;http:\/\/www.cdc.gov\/drugoverdose\/pdf\/pharmacists_brochure\u2010a.pdf. 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