CME: Examining Medicare Prescribing of Painkillers

CME: Examining Medicare Prescribing of Painkillers

According to published data, there has been a 10-fold increase in the misuse of opioid painkillers in the United States over the past 2 decades. Questions remain, however, about the causes that are driving this trend. “Some researchers and experts have suggested that small groups of high-volume prescribers working in so-called ‘pill mills’ are among the main reasons for the opioid overdose epidemic in the U.S.,” explains Anna Lembke, MD. “Despite this belief, opioid overprescribing is more than just a problem of a small group of high-volume prescribers,” adds Dr. Lembke.   Taking a Closer Look In a research letter published in JAMA Internal Medicine, Dr. Lembke and colleagues examined data from individual prescribers using the 2013 Medicare Part D claims data set created by CMS. Medicare data provide the opportunity to address the issue of opioid prescribing patterns across the nation. Medicare Part D covers about 68% of the roughly 50 million people on Medicare. For the more than 800,000 prescribers assessed in the study, data were examined on each drug prescribed, the total number of claims, and total costs. Data were available on both location and specialty of practice, and represented nearly 1.2 billion claims for approximately $81 billion. The analysis focused on schedule II opioid prescriptions containing hydrocodone, oxycodone, fentanyl, morphine, methadone, hydromorphone, oxymorphone, meperidine, codeine, opium, or levorphanol. The authors then calculated the cumulative claims for schedule II opioids from the top individual prescribers relative to the total claims for all prescribers. For comparisons, this exercise was repeated for prescription costs, for all drugs, and for each state.   Important Trends The study showed that the largest...
Examining Medicare Prescribing of Painkillers

Examining Medicare Prescribing of Painkillers

According to published data, there has been a 10-fold increase in the misuse of opioid painkillers in the United States over the past 2 decades. Questions remain, however, about the causes that are driving this trend. “Some researchers and experts have suggested that small groups of high-volume prescribers working in so-called ‘pill mills’ are among the main reasons for the opioid overdose epidemic in the U.S.,” explains Anna Lembke, MD. “Despite this belief, opioid overprescribing is more than just a problem of a small group of high-volume prescribers,” adds Dr. Lembke.   Taking a Closer Look In a research letter published in JAMA Internal Medicine, Dr. Lembke and colleagues examined data from individual prescribers using the 2013 Medicare Part D claims data set created by CMS. Medicare data provide the opportunity to address the issue of opioid prescribing patterns across the nation. Medicare Part D covers about 68% of the roughly 50 million people on Medicare. For the more than 800,000 prescribers assessed in the study, data were examined on each drug prescribed, the total number of claims, and total costs. Data were available on both location and specialty of practice, and represented nearly 1.2 billion claims for approximately $81 billion. The analysis focused on schedule II opioid prescriptions containing hydrocodone, oxycodone, fentanyl, morphine, methadone, hydromorphone, oxymorphone, meperidine, codeine, opium, or levorphanol. The authors then calculated the cumulative claims for schedule II opioids from the top individual prescribers relative to the total claims for all prescribers. For comparisons, this exercise was repeated for prescription costs, for all drugs, and for each state.   Important Trends The study showed that the largest...