Opioid Prescriptions Given To One-Third of Medicare Beneficiaries Amid Abuse Epidemic: Report

More than one-third of Medicare patients are given commonly abused narcotic painkiller prescriptions, according to the findings of a new federal report, which highlights increasing concerns about the scope of the opioid abuse epidemic in the United States. 

The U.S. Department of Health & Human Services Office of Inspector General (OIG) released a new report (PDF) this month, detailing Medicare spending trends and questionable billing by pharmacies.

The report involves an analysis of prescription drug event records from 2006 to 2015, identifying nearly 12 million Medicare patients who received at least one prescription for narcotic painkillers last year. That statistic is particularly concerning, as opioid overdose deaths have increased in recent years.

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More than one-third of beneficiaries received at least one commonly abused opioid, such as OxyContin or fentanyl. Of the patients who received opioids, each had an average of five prescriptions or refills.

The most common opioid drugs prescribed to Medicare patients were OxyContin, Percocet, Vicodin, fentanyl, and other generic equivalents. There were more than 40 million prescriptions for these drugs last year alone.

The OIG found that Medicare spending for Part D drugs rose by more than $10 billion a year. Spending on commonly abused opioid drugs exceeded $4 billion in 2015 and “spending on compounded drugs increased dramatically.”

Overall, the report revealed 2015 Part D spending reached $137 billion. It was the third consecutive year spending increases surpassed $10 billion.

Opioid Abuse Epidemic

The findings of the new study concern health officials amid the worsening opioid abuse and overdose epidemic that is sweeping the nation. A report released in May revealed the opioid epidemic has begun to strain intensive care units to their breaking point, with opioid related admissions nearly doubling between 2011 and 2015.

In 2015, the Medicare system flagged nearly 16,000 patients last year as potential drug users. The report raises concerns about the safety of patients, fraud and abuse.

There were nearly 19,000 fatal overdoses on narcotic painkiller medications in 2014, the most on record. A report released in May by the American Association of Poison Control Centers revealed more than 3,000 reports are received each month involving opioid exposure, overuse and abuse.

A study published earlier this month concluded doctor monitoring programs may help reduce the rate of narcotic painkillers prescribed, helping to reduce opioid prescriptions by 30 percent. The overdose rates and epidemic also have the FDA considering new requirements calling for mandatory specialized doctor training for those who prescribe opioids.

The OIG said it will continue to investigate the spending and potential abuse, but calls on doctors to help patients consider alternatives for chronic pain, including meditation, yoga, ice therapy and walking.

The agency plans to take further steps to identifying high risk patients and outlier prescribers, as well as fully implementing previous recommendations to curb abuse.

“Ensuring the appropriate use of opioids and compounded drugs is critical to protecting the safety of Medicare beneficiaries and ensuring the integrity of the Medicare program,” said the OIG in a statement concerning the report.

The OIG also warned opioid use is not just a problem for young people. Use among older Americans is also high, and their risk of overdose and abuse is heightened by interactions with other medications and alcohol.


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