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Войти в исследования The International journal on drug policy · 2026
Early effects of scheduling gabapentin on medication adherence among epilepsy patients on gabapentin in Virginia.
СтатьяНазвание и аннотация: Перевод в очереди
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Wetzel Martha, Howard David H, Giordano Nicholas A, Patrick Stephen W, Yarbrough Courtney R
Аннотация
BACKGROUND: Due to concerns about misuse and diversion, eight states have scheduled gabapentin as a controlled substance. The effect of this change on patient adherence is unknown.
OBJECTIVES: To estimate the effect of Virginia's scheduling of gabapentin on medication adherence among epilepsy patients.
RESEARCH DESIGN: Using all-payer claims data from Virginia and Colorado for 2017-2019, we identified patients with focal seizures who had a claim for gabapentin, pregabalin, or levetiracetam. The primary outcome was proportion of days covered over six-month periods. Effects were estimated using a triple-difference approach comparing patients 1) pre- vs. post-policy, 2) in Virginia vs. Colorado, and 3) on gabapentin vs a comparison medication. Analyses were repeated excluding patients with opioid claims.
RESULTS: Gabapentin scheduling in Virginia was associated with a 3.6 (SD: 1.1, p-value <0.001) percentage point decrease in proportion of days covered. The share of epilepsy patients with ≥80% of days covered decreased from 67.5% to 60.2% (adjusted difference: -7.5%, SD: 2.2, p-value <0.001). The proportion of gabapentin patients with a concurrent opioid prescription did not significantly change and excluding these patients had minimal effect.
CONCLUSIONS: In the six months following Virginia's policy change, scheduling gabapentin was associated with a decline in the proportion of days covered among epilepsy patients. Given ongoing state-level gabapentin policy changes, continued research on the impacts of scheduling gabapentin on patient care and barriers to medication access is warranted.
OBJECTIVES: To estimate the effect of Virginia's scheduling of gabapentin on medication adherence among epilepsy patients.
RESEARCH DESIGN: Using all-payer claims data from Virginia and Colorado for 2017-2019, we identified patients with focal seizures who had a claim for gabapentin, pregabalin, or levetiracetam. The primary outcome was proportion of days covered over six-month periods. Effects were estimated using a triple-difference approach comparing patients 1) pre- vs. post-policy, 2) in Virginia vs. Colorado, and 3) on gabapentin vs a comparison medication. Analyses were repeated excluding patients with opioid claims.
RESULTS: Gabapentin scheduling in Virginia was associated with a 3.6 (SD: 1.1, p-value <0.001) percentage point decrease in proportion of days covered. The share of epilepsy patients with ≥80% of days covered decreased from 67.5% to 60.2% (adjusted difference: -7.5%, SD: 2.2, p-value <0.001). The proportion of gabapentin patients with a concurrent opioid prescription did not significantly change and excluding these patients had minimal effect.
CONCLUSIONS: In the six months following Virginia's policy change, scheduling gabapentin was associated with a decline in the proportion of days covered among epilepsy patients. Given ongoing state-level gabapentin policy changes, continued research on the impacts of scheduling gabapentin on patient care and barriers to medication access is warranted.