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Objectives: OxyContin® was reformulated with a polyethylene oxide matrix in August 2010 to reduce the potential for intravenous abuse and for abuse by insufflation. The objective of this study was to evaluate the impact of OxyContin’s reformulation on overdose risk for individuals dispensed OxyContin in comparison to those dispensed other opioids under regular care. Methods: Three national insurance databases with National Death Index linkage identified OD in individuals with any dispensing of OxyContin or a primary comparator opioid (ER morphine, transdermal fentanyl, or methadone) between July 2008 through September 2015. A difference-in-differences design was used to compare the pre-post reformulation changes in OD rates for OxyContin versus comparators. Results: 297,836 individuals were dispensed OxyContin and 659,673 individuals were dispensed a primary comparator across the three databases. Overall, there was little or no difference in the temporal change in OD incidence in comparators versus OxyContin (Medicaid: adjusted ratio-of-rate-ratios (aRoRs) ranging from 0.90 to 1.05; MarketScan/HIRD: aRoR ranging from 1.10 to 1.22). However, restriction to person-time without concomitant opioid use revealed a modestly greater reduction in OD incidence over time during OxyContin use, as the aRoRs comparing the primary comparators to OxyContin ranged from 1.06 to 1.30 in Medicaid and from 1.64 to 1.85 in MarketScan/HIRD. Discussion: This study did not detect an overall effect of the OxyContin reformulation on OD in insured patients under regular medical care. There is a suggestion of a modestly reduced OxyContin-associated OD risk following the reformulation but only in commercially-insured individuals receiving single-opioid regimens.


Beachler, Daniel C. PhD*; Hall, Kelsey*; Garg, Renu*; Banerjee, Geetanjoli*; Li, Ling*; Boulanger, Luke†; Yuce, Huseyin‡; Walker, Alexander M.§ An Evaluation of the Effect of the OxyContin® Reformulation on Unintentional Fatal and Non-fatal Overdose, The Clinical Journal of Pain: March 31, 2022 - Volume - Issue - 10.1097/AJP.0000000000001034 doi: 10.1097/AJP.0000000000001034

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article Distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.



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