Rescheduling Hydrocodone Combination Products (HCPs): Impact on patients receiving long-term HCP therapy in a Large Chain Pharmacy – a Statewide Assessment

Abstract: Objectives To evaluate the rescheduling of hydrocodone combination products (HCP) from schedule III (CIII) to schedule II (CII) in patients receiving chronic HCP therapy. Methods This study was a retrospective, cohort analysis of administrative pharmacy data from 118 statewide pharmacies from a retail chain in Tennessee. HCP filling histories were analyzed on patients meeting enrollment criteria from July 1, 2014, to October 1, 2015. The average number of tablets dispensed, daily average of the number of tablets dispensed, and monthly average of morphine milligram equivalents (MME) dispensed were compared for the periods of July 1, 2014 to October 5, 2014 (enrollment period before schedule change) and October 6, 2014 to October 1, 2015 (period following schedule change) using a pooled t-test. Results A total of 4536 patients met the inclusion criteria. Of these 4536 patients, 60.6% were female and 40.4% were male, with an average age of 58 years (patients included in this study ranged from the ages of 18 to 99 years). The total number of hydrocodone tablets dispensed in the twelve-periods after the schedule change dropped from 467,217 to 259,327, a 45.5% reduction (p Conclusion Hydrocodone combination product dispensing and utilization decreased among patients receiving chronic opioid treatment from a large corporate state-wide retail pharmacy in Tennessee following a schedule change from CIII to CII. Monthly sums of total tablets dispensed, average daily tablets dispensed, MME and, average daily MME calculated for the time period of July 1, 2014 to October 1, 2015 all experienced statistically significant reductions.