Description of Strategy
A pharmacy lock-in program is used to constrain patients with a history of obtaining excessive quantities of controlled substances through multiple visits to providers and pharmacies. This program requires that once patients are evaluated, and prescribed opioids by a licensed provider, they utilize a single pharmacy for filling all of their prescriptions. This reduces the likelihood of duplicate or excessive prescriptions.
Wyoming Medicaid includes a pharmacy lock-in program.
Discussion of Effectiveness
The existing research concerning the effectiveness of pharmacy lock-in programs is mixed. Naumann et al. (2018) find that lock-in programs increase the number of prescriptions written for narcotics using non-Medicaid payment options. Meanwhile, Roberts et al. (2016) argues that enrolled patients can simply pay full price out of pocket for prescriptions filled at a pharmacy where they are not locked in. For example, a study of Michigan’s lock-in program found that 56% of patients simply dropped the program. However, those that remained in the program were more likely to use opioids appropriately (Dreyer et al., 2015).
Dreyer, T.R.F., Michalski, T., & Williams, B.C. (2015). Patient outcomes in a Medicaid managed care lock-in program. Journal of Managed Care & Specialty Pharmacy, 21(11), 1006 – 1012.
Naumann, R. B., Marshall, S. W., Lund, J. L., Gottfredson, N. C., Ringwalt, C. L., & Skinner, A. C. (2018). Evaluating short- and long-term impacts of a Medicaid “lock-in” program on opioid and benzodiazepine prescriptions dispensed to beneficiaries. Drug and Alcohol Dependence, 182(1), 112–119.
Roberts, A. W., Farley, J. F., Oramasionwu, C. U., Ringwalt, C., Sleath, B., Skinner, A. C. (2016). Controlled substance lock-in programs: Examining an unintended consequence of a prescription drug abuse policy. Health Affairs, 35(10), 1884–1892.
Wyoming Department of Health. (n.d.) Wyoming Pharmacy Lock-In Program.