INFLUENCE OF TRIPLICATE POLICY ON NARCOTIC UTILIZATION

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Due to their potential to be abused by patients and non-patients alike, narcotics are extensively regulated by state and federal laws and regulations. Although state and federal governments employ a variety of mechanisms to control drug utilization and attendant costs, triplicate, or Multiple Copy Prescription Programs (MCPPs), are an increasingly popular strategy used to control narcotic utilization at the retail level. Despite the widespread adoption of MCPPs, however, there has inadequate evaluation of their effectiveness, impact on physician prescribing patterns, and effect on patient care. The purpose of this study is to examine the patient, physician, and state regulatory characteristics which may influence the utilization of analgesic drugs. Specifically, the analysis will emphasize the impact of MCPPs on narcotic and non-narcotic analgesic utilization, while considering the influence of other factors, namely patient sociodemographic characteristics, patient health status, and physician practice characteristics. This study uses cross-sectional data from the 1989 National Ambulatory Medical Care Survey (NAMCS), a survey of 38,384 office visits to 1,876 physicians. In addition, NCHS will incorporate four variables, including MCPP status, describing the prescription regulatory environment. Using logistic and multinomial regression techniques, the study will estimate the patient, physician, and regulatory variables predicting analgesic drug utilization. The study aims to answer four questions: 1) How do patient, physician, and state factors for office visits resulting in an analgesic drug differ from those which do not? 2) How do patterns of narcotic utilization in office-based medical practice in MCPP states differ from non-MCPP states? 3) Do patient characteristics have a differential impact on prescribing patterns in MCPP states relative to non-MCPP states? 4) Do physician characteristics have a differential impact on prescribing patterns in MCPP states relative to non-MCPP states? In response to rising drug costs and the problem of prescription drug abuse and misuse, state and federal governments are increasing scrutiny of prescription drugs in patient care. It is important, therefore, for policy makers to understand how programs intended to curb drug use, as well as other, non-program specific factors such as patient and physician characteristics, affect the distribution and utilization of drugs. The findings from this study will provide insight into these issues.