Emergency Providers' Opioid Prescribing Behaviors Among Medicare Part D Beneficiaries in North Carolina, 2013-2014: Medication Utilization and Costs.

Abstract

BACKGROUND This study sought to quantify utilization and costs associated with opioid prescribing by emergency providers for Medicare Part D beneficiaries in North Carolina and the United States from 2013 to 2014.METHODS This was a retrospective examination of the Medicare Provider Utilization and Payment Data: Part D Prescriber datasets from 2013-2014. The main variables of interest were total number of prescription claims and total Medicare Part D medication costs for opioid analgesic medications. Generalized estimating equations were used to analyze the data.RESULTS Excluding North Carolina, there were 2,030,108 (678.49 per 100,000) opioid claims in the United States in 2013, costing more than $28.3 million. In 2014, also excluding North Carolina, there were 2,061,992 (689.15 per 100,000) claims for opioids, costing almost $35.8 million. In North Carolina, there were 67,570 (708.62 per 100,000) opioid claims from emergency providers in 2013 and 72,881 (764.31 per 100,000) opioid claims in 2014 for Part D beneficiaries. Total Part D drug costs associated with opioids from North Carolina increased from $545,574 to $764,016, more than a 40% increase. In North Carolina, there was a statistically significant increase in costs (P < .001), but not a significant increase in numbers of claims (P = .051).LIMITATIONS This study did not examine patient-level data and could not examine diagnoses leading to opioid prescriptions, or opioid misuse or overdoses.CONCLUSION Almost 1 out of every 4 Part D prescriptions from emergency department providers in North Carolina was for an opioid medication. Given the recent focus on controlling opioid prescribing, future research should examine if the new opioid-prescribing guidelines reduced opioid prescription by these providers.