[Skip to Content]
[Skip to Content Landing]
Article
November 6, 1991

Consequences of the 1989 New York State Triplicate Benzodiazepine Prescription Regulations

Author Affiliations

From the Departments of Community and Preventive Medicine (Drs Weintraub and Singh and Ms Byrne), and Psychiatry (Mr Maharaj and Dr Guttmacher), University of Rochester School of Medicine and Dentistry, Rochester, NY.

From the Departments of Community and Preventive Medicine (Drs Weintraub and Singh and Ms Byrne), and Psychiatry (Mr Maharaj and Dr Guttmacher), University of Rochester School of Medicine and Dentistry, Rochester, NY.

JAMA. 1991;266(17):2392-2397. doi:10.1001/jama.1991.03470170080028
Abstract

Objective.  —Comparison of psychoactive medication prescribing and Medicaid expenditures before (1987 through 1988) and after (1989 through 1990) institution of the New York State triplicate benzodiazepine regulations.

Data Sources.  —The National Prescription Audit (IMS America, Plymouth Meeting, Pa), New York State Medicaid, and Blue Cross/Blue Shield of the Rochester (NY) Area.

Results.  —From 1988 to 1989, New York State benzodiazepine prescribing decreased by 44%, 60%, and 30% as assessed by IMS America, Medicaid, and Blue Cross/Blue Shield, respectively. Prescribing of the following alternative sedative-hypnotics increased in New York State compared with decreases nationally (IMS America data): meprobamate, +125% vs -9%; methyprylon, +84% vs -15%; ethchlorvynol, +29% vs -18%; butabarbital, +31% vs -15%; hydroxyzine, +15% vs -1.1%; and chloral hydrate, +136% vs - 0.4%. Increased prescribing of alternatives was also seen in the Medicaid and Blue Cross/Blue Shield data. Medicaid benzodiazepine expenditures decreased 52% from 1988 to 1989 ($21.7 million to $10.4 million). Alternative sedative expenditures increased 115% ($3.9 million to $8.4 million). Total Medicaid psychoactive medication expenditures remained nearly constant ($46.7 million to $45.6 million).

Conclusion.  —Although the triplicate regulations have decreased benzodiazepine prescribing, an undesirable increase has occurred in the prescribing of less acceptable medications. The wider public health, patient care, and financial implications of triplicate benzodiazepine regulations are of concern and require further study before other jurisdictions undertake similar programs.(JAMA. 1991;266:2392-2397)

×