Purdue Pharma L.P. to Present Data from Three Research Studies at
PAINWeek® 2018 Annual Conference

Studies Underscore Company’s Ongoing Commitment to Working Collaboratively on
Meaningful Solutions to Address the Opioid Crisis

STAMFORD, Conn., September 6, 2018 – Purdue Pharma L.P. will present the results of three studies at the 12th Annual PAINWeek® Conference, September 4-8, 2018, Las Vegas.

The posters will be available for viewing after 3:30 p.m. PDT on Wednesday, September 5, 2018. Authors will be available to discuss their posters during the PAINWeek® Poster Session and Reception on Thursday, September 6, 2018 from 6:30-8:30 p.m. PDT.

Poster #118
Initial Opioid Prescription Characteristics and Subsequent Factors Influencing Diagnosed Opioid Use Disorder in a State Medicaid Program
Authors: Timothy T. Pham, PhD; Grant H. Skrepnek, PhD; Christopher Bond, PhD; Thomas Alfieri, PhD; Terry J. Cothran, DPh; Shellie L. Keast, PhD

Oklahoma state Medicaid pharmacy and medical claims data from 2011-2017 were used to evaluate the effect of initial prescription dose on diagnosed opioid use disorders (DOUD) through a random-effects parametric survival adjusted model. The effects of several variables were estimated, including opioid dose escalation, change in opioid type, new prescriber, use of benzodiazepines and gabapentin after initial opioid prescription, emergency room (ER) visits and hospitalizations, and the presence of any 30-day opioid-free period.

Of 147,777 adults with at least one opioid prescription, 5.3% had a DOUD subsequently recorded. Variables significantly associated with DOUD development include previous non-opioid substance abuse or poisoning (28.7% for DOUD cases versus 16.5% for non-cases, p<0.001) and prior anxiety diagnosis (14.1% vs. 7.5%, p<0.001). In adjusted analyses, there was a direct relationship between total dose for initial opioid prescription and DOUD risk. Post-index events had a significant effect in a time-dependent model (adjusted hazard ratios with accompanying 95% confidence intervals):

  • Benzodiazepine use prior to the index opioid prescription carried an increased risk (1.25; 1.09-1.43), but initiation of benzodiazepine post-index in those not using it before had an even greater risk (2.24; 2.08-2.42)
  • Gabapentin use after the index opioid prescription was also a risk factor (1.81; 1.19-2.76)

“The opioid crisis is complex and multiple risk factors are associated with poor outcomes. Although causality cannot be inferred, the study did find that opioid users who switch to a different opioid, have doses increased, and have gabapentin and benzodiazepines introduced after the start of opioid therapy should be closely monitored,” said Marcelo E. Bigal, MD, PhD, chief medical officer, Purdue Pharma. “We hope this study provides additional information for physicians to consider as part of ongoing efforts to provide optimal care while minimizing the risks for patients with severe chronic pain for whom non-opioid treatment options are inadequate.”

“This research supports our strong interest in and commitment to helping patients, including Medicaid members living with pain and economic challenges,” said Shellie L. Keast, PhD, University of Oklahoma College of Pharmacy, Oklahoma City, Okla. “While benzodiazepines have been reported frequently in deaths involving opioid analgesics, we believe results of this study are novel and recognition of how and when benzodiazepines and gabapentin are used concurrently may help inform future opioid abuse interventions.”

Poster #117
Pilot to Integrate Virginia PDMP Data into Electronic Health Records
Authors: Thomas Alfieri, PhD; Lisa C. Miller, PharmD

Prescription Drug Monitoring Programs (PDMPs), electronic databases that track controlled substance prescriptions, can be used to help inform physicians’ clinical and prescribing decisions. Implementation and use of PDMPs vary from state to state. Some studies have found state legislation mandating use is associated with a decrease in the number of opioid prescriptions, average daily morphine milligram equivalents, and the number of opioid and benzodiazepine pills dispensed, while other studies failed to demonstrate the benefit.1-3

In 2017, Purdue Pharma and the Commonwealth of Virginia created a public-private partnership to connect PDMP data with Electronic Health Records (EHR) at select healthcare settings and within pharmacy dispensing systems. The assumption was that placing PDMP information into these environments carried the potential to improve access to and utilization of PDMP data by making it an integral part of the clinical workflow.

An observational study examined PDMP usage data, IQVIA National Prescription Audit (NPA) data regarding the number of opioid prescriptions, and statistics published by The Virginia Department of Health Professions regarding opioid prescription-days, multiple provider episodes, and opioid-benzodiazepine overlap during Q1 2018 (January, February, and March 2018), and compared these statistics to similar metrics during Q1 2017 (January, February, and March 2017). The study found:

  • A 91% increase in the average monthly number of unique individuals interacting with the Virginia PDMP (from 7,959 to 15,175 within one year).
  • Mean monthly opioid prescriptions decreased by 17% in Virginia, which was greater than the 12% national average decrease.
  • Multiple provider episodes (patients receiving opioids from at least five different prescribers and five different pharmacists within a six-month period) decreased by 60%.
  • A 14% percent reduction in the percentage of days patients in Virginia had overlapping prescriptions for opioids and benzodiazepines.

Poster #110
Pharmacist Awareness of the DEA National Prescription Drug Take Back Day
Authors: Stacy Baldridge, PhD, RN; Thomas Alfieri, PhD; Rupa Shah, PharmD

Up to 40% of dispensed prescription medications are not completely used during treatment and are likely to remain in the home, where the storage may not be secure.4 The Drug Enforcement Administration (DEA) Prescription Drug Take Back Days program provides the opportunity for individuals to properly dispose unused prescription drugs.5

Healthcare professionals from Purdue Pharma with training in pain care visited 138 pharmacies in nine states (Calif., Conn., Mass., Minn., N.C., N.Y., Pa., S.C., and Texas) in April 2018. The primary objective of these visits was to raise awareness of the upcoming Prescription Drug Take Back Day, and engage pharmacists to encourage their patients to participate in proper disposal of their unused, unwanted, or expired medications.

Pharmacists received printed materials developed by the DEA (in English and Spanish) that could be displayed in pharmacies. Some pharmacists voluntarily participated in discussions regarding their needs and challenges and those of patients as related to controlled substances. Key insights from the discussions were documented in an electronic database and qualitative exploratory analyses were conducted.

Of the 138 pharmacists approached in the retail setting, approximately half (n=67) agreed to participate. Of those:

  • The most frequently mentioned topic was medication disposal options, such as in-pharmacy disposal boxes and medication disposal bags, and patient education on those options (n=30).
  • 72% of pharmacists (n=48) were aware of the upcoming DEA event, but only 19% of pharmacists (n=13) described active efforts to counsel patients on proper medication disposal.

“Pharmacists play a critical role in educating patients with accurate information about prescription medication safety, storage, and disposal options, and the pharmacists surveyed recognize the importance of this information for patients and caregivers,” said Stacy Baldridge, PhD, RN, associate director, Purdue Pharma. “This survey underscores a need for increased awareness about proper disposal of unused medications. Safe disposal is a critical step to ensuring prescription opioids are not diverted for non-medical use.”

Please visit this website for more information about the DEA’s upcoming Prescription Drug Take Back Day, taking place on October 27, 2018.

About Purdue Pharma L.P.

Purdue Pharma L.P. develops and provides prescription medicines that meet the evolving needs of healthcare professionals, patients, and caregivers. We were founded by physicians and we are currently led by a physician. Beyond our efforts to provide quality medications, Purdue is committed to supporting national, regional and local collaborations to drive innovations in patient care. Privately held, Purdue is pursuing a pipeline of new medications and technologies through internal research & development and strategic industry partnerships. For more information, please visit www.purduepharma.com.

References:

1 Haffajee RL, et al. Four states with robust prescription drug monitoring programs reduced opioid dosages. Health Affairs. 2018;37(6):964-974.
2 Winstanley EL, et al. Mandatory review of a prescription drug monitoring program and impact on opioid and benzodiazepine dispensing. Drug and Alcohol Dependence. 2018; 188:169-174.
3 Paulozzi LJ, Kilbourne EM, Desai HA. Prescription drug monitoring programs and death rates from drug overdose. Pain Med. 2011;12(5):747‑754.
4 Lewis ET, Cucciare MA, Trafton JA. What do patients do with unused opioid medications? Clin J Pain. 2014;30(8):654-662.
5 Egan KL, Gregory E, Sparks M, Wolfson M. From dispensed to disposed: evaluating the effectiveness of disposal programs through a comparison with prescription drug monitoring program data. Am J Drug Alcohol Abuse. 2017;43(1):69-77.

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