The Effect of Informative Letters on the Prescription and Receipt of Schedule II Controlled Substances

Abdul Latif Jameel Poverty Action Lab

Status: Completed

Conditions: Delivery of Health Care; Economics; Health Expenditures; Fraud; Centers for Medicare and Medicaid Services (U.S.)

Treatments: Other: Informative letter

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT02345434

JPAL-LETTERS-SII

Details and patient eligibility

About

Fraud and waste is estimated to cost the American health care system nearly $200 billion each year, and the public Medicare and Medicaid programs about $60 billion each year. This study will evaluate a new method for fighting fraud: mailing informative letters to outlier providers to notify them of their aberrant behavior. These letters are targeted at high prescribers of schedule II controlled substances in Medicare Part D. The investigators will look at the effects of these letters on the behavior of providers and their patients. These effects are of substantial policy interest as they suggest how to best design anti-fraud policies. They are also of academic interest, shedding light on the behavior of physicians and their patients.

Enrollment: 1,525 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Outlier with respect to the count of schedule II prescription drug events relative to peer group of prescribers in two of the three years 2011, 2012, and 2013
• Outlier with respect to the 30-day equivalent prescriptions of schedule II substances relative to peer group of prescribers in two of the three years 2011, 2012, and 2013

Exclusion criteria

• Deceased

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,525 participants in 2 patient groups

No informative letter

No Intervention group

Description:

This is the control arm and it involves no contact with the prescriber

Informative letter

Experimental group

Description:

This is the treatment arm; prescribers in this arm receive an informative letter (called a comparative billing report or peer activity report)

Treatment:

Other: Informative letter