HealthDay News — The top 10% of Medicare prescribers account for more than 50% of opioid claims, compared with almost 80% for the top 10% of the California Workers’ Compensation providers, according to a research letter published in JAMA Internal Medicine.

Jonathan H. Chen, MD, PhD, from the Veterans Affairs Palo Alto Health Care System in California, and colleagues examined data from individual prescribers from the 2013 Medicare Part D claims data set. For each prescriber National Provider Identifier number they obtained data on each drug prescribed, total number of claims, and total costs, focusing on schedule II opioid prescriptions.

The researchers found that the prescriber specialties that accounted for the most opioid drug claims were interventional pain management, pain management, anesthesiology, and physical medicine and rehabilitation. The top 10% of Medicare prescribers accounted for a smaller proportion of opioid claims than for all Medicare prescriptions and for the California Workers’ Compensation prescribers (56.7, 63, and 79%, respectively). Across provider states there was minimal regional variation. The trends were similar when excluding hydrocodone, with the same top three prescribing specialties and with the top 10% of prescribers accounting for 57.9% of claims.

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“High-volume prescribers are not alone responsible for the high national volume of opioid prescriptions,” the authors write.


Chen JH, Humphreys K, Shah NH, Lembke A. Distribution of Opioids by Different Types of Medicare Prescribers. JAMA Intern Med. 2015;:1-3.