Retail Access Restrictions

Retail access restrictions involve policies and regulations that limit access to commonly abused prescription drugs. When a person goes to a pharmacy to fill a prescription, there may be rules and guidelines on how many pills can be dispensed at a time, or how many prescriptions can be dispensed at once. These restrictions can be instituted by government entities, but also by health insurance companies. The main idea is to limit the amount or type of prescription drugs one person can obtain individually in order to reduce doctor shopping behavior and to reduce the amount of controlled drugs in circulation throughout the community. The evidence of the effectiveness of these strategies are limited but promising. For example, doctor shopping laws when implemented in conjunction with Prescription Drug Monitoring Programs have been associated with a reduction in doctor shopping behavior and obtainment of nonmedically-necessary prescriptions.1 In addition, Patient Review and Restriction Programs have been associated with a reduction in expenditures and use of controlled substances.2

Retail access restrictions, summarized here, include the following:

1 Pearson, S.-A., Soumerai, S., Mah, C., Zhang, F., Simoni-Wastila, L., Salzman, C.,  . . .  Ross-Degnan, D. (2006). Racial disparities in access after regulatory surveillance of benzodiazepines. Archives of Internal Medicine, 166(5), 572–579. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/409923

Pradel, V., Frauger, E., Thirion, X., Ronfle, E., Lapierre, V., Masut, A.,  . . .  Micallef, J. (2009). Impact of a prescription monitoring program on doctor-shopping for high dosage buprenorphine. Pharmacoepidemiology and Drug Safety, 18(1), 36–43.

2 Blake, S. G. (1999, March). Drug expenditures: The effect of the Louisiana Medicaid lock-in on prescription drug utilization and expenditures. Drug Benefit Trends, 11(3), 45–55; Chinn, F. J. (1985). Medicaid recipient lock-in program—Hawaii’s experience in six years. Hawaii Medical Journal, 44(1), 9–18; and Mitchell, L. (2009). Pharmacy lock-in program promotes appropriate use of resources. Oklahoma State Medical Association Journal, 102(8), 276.