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

NCT02345434 | Completed Results

• 1 other identifier: JPAL-LETTERS-SII
• Study Type: interventional
• Target: 1,525
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

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

Outcome Measures

Primary Outcomes (1)

• 30-day Equivalent Prescribing of Schedule II Controlled Substances

  The prescribing of schedule II controlled substances over the 3 months following the initial sending of the letters. Prescribing is defined as the total "days supply" of schedule II controlled substances attributed to the prescriber, expressed in "30-day equivalents" i.e. divided by 30.

  3 months

Secondary Outcomes (4)

• 30-day Equivalent Prescribing of Schedule II Controlled Substances

  1 month

• 30-day Equivalent Prescribing of Schedule II Controlled Substances

  6 months

• 30-day Equivalent Prescribing of Schedule II Controlled Substances

  9 months

• 30-day Equivalent Prescribing of Schedule II Controlled Substances

  1 year

Study Arms (2)

No informative letter

NO INTERVENTION

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

Informative letter

EXPERIMENTAL

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

Other: Informative letter

Interventions

Informative letter OTHER

The intervention is a letter that describes the Schedule II prescribing activity of the individual in comparison to a peer group of similar prescribers. It highlights the fact that the prescriber's activity is highly unlike her peers.

Also known as: Comparative billing report, Peer activity report

Informative letter

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• \- Deceased

Sponsors & Collaborators

• Abdul Latif Jameel Poverty Action Lab: lead
• Centers for Medicare and Medicaid Services: collaborator
• General Services Administration (GSA): collaborator

Related Links

• American Economic Association Randomized Controlled Trials Registry Entry

Results Point of Contact

• Title: Adam Sacarny
• Organization: Columbia University

ajs2102@columbia.edu

212 305 7084

Study Officials

• Amy Finkelstein, PhD

  Massachusetts Institute of Technology

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 6, 2014
• First Posted: January 26, 2015
• Study Start: August 1, 2014
• Primary Completion: August 1, 2015
• Study Completion: August 1, 2015
• Last Updated: November 8, 2021
• Results First Posted: November 8, 2021

Record last verified: 2021-10