PNS83 MEDICARE PART D PRESCRIPTION PAYMENTS BY PRESCRIBER SPECIALTY TYPE IN 2017

Abstract

Medicare Part D prescription expenditures across prescriber specialties varied by different medical specialty’s preferences or prescribing patterns. Better understanding of the prescribers’ preference and patterns can help form strategies to reduce Part D expenditures. The objective of this study was to describe Medicare Part D prescription payments by prescriber specialty type for better understanding prescription utilization and needs among Medicare population. This cross-sectional analysis used the recently available 2017 Medicare Part D Prescriber Public Use and Summary data files. Total Medicare Part D Payments and number of Part D prescriptions were aggregated by specialist groups. Payments per monthly supply of drugs were calculated by dividing the total payments by aggregated monthly supply of drugs for each individual prescriber. The proportion of generic claims in each prescriber specialty was calculated by all generic medication claims divided by the total medication claims. Internal medicine, family practice, and nurse practitioner represented the highest total number of Part D prescribers and highest total Medicare Part D payments ($31 billion, $26 billion, and $15 billion, respectively). The top 3 specialties with highest median payment per monthly supply of drugs were hematology/oncology, medical oncology, and infectious disease ($1.01 thousand, $0.96 thousand, and $0.69 thousand, respectively). Part D prescriber specialty types in pulmonary disease, endocrinology, and ophthalmology had the lowest proportion of generic claims among all specialty groups (41%, 45%, and 53%, respectively). Internal medicine, family practice, and nurse practitioner were the top 3 medical groups with the highest total Medicare Part D payments. Prescribers specialized in oncology and infectious disease had the highest payment per monthly supply of medications. Medicare Part D payment to low proportion of generic claims such as pulmonary disease, endocrinology, and ophthalmology could be reduced by increasing generic drug utilization.