Nav: Home

Study examines opioid agonist therapy use in Medicare patients

July 20, 2016

Few Medicare enrollees appear to be receiving buprenorphine-naloxone, the only opioid agonist therapy for opioid addiction available through Medicare Part D prescription drug coverage, according to a study published online by JAMA Psychiatry.

Opioid overdose rates reached record highs in 2014. The Medicare population has among the highest and fastest growing prevalence of opioid use disorder, with more than 6 of every 1,000 patients (an estimated 300,000 of 55 million) diagnosed. Opioid agonist therapy (OAT), including buprenorphine-naloxone and methadone, is the most effective drug therapy for opioid addiction. Medicare Part D does not pay for methadone maintenance therapy so buprenorphine-naloxone is the only Medicare covered option for patients addicted to opioids. Part D covers 68 percent of the roughly 55 million people on Medicare.

Anna Lembke, M.D., and Jonathan H. Chen, M.D., Ph.D., of the Stanford University School of Medicine, California, examined 2013 Medicare Part D claims data from individual prescribers.

The authors identified 6,707 prescribers with 486,099 claims for buprenorphine-naloxone, which were written for about 81,000 patients, according to the results.

The data suggests that:
  • For every 40 family practice physicians who prescribed an opioid painkiller, only one family practice physician prescribed buprenorphine-naloxone.

  • Pain physicians averaged a negligible number of buprenorphine-naloxone prescriptions per prescriber (mostly less than five) while averaging thousands of opioid prescriptions.

  • Prescribers with a primary specialty in addiction medicine prescribed the most buprenorphine-naloxone with nearly 99 claims per year per prescriber.

Authors note the data do not necessarily completely reflect clinician practices or patient factors.

"Approximately 81,000 Medicare enrollees are receiving buprenorphine-naloxone therapy (the only OAT available through Medicare part D) despite more than 300,000 Medicare patients estimated to be struggling with an opioid use disorder and 211,200 per year requiring hospitalization for opioid overuse. We believe this reflects a significant treatment gap, although we are limited in providing precise estimates; not all patients with an opioid use disorder warrant OAT but, on the other hand, opioid disorders are systematically underdiagnosed and increasing in prevalence," the study concludes.
-end-
(JAMA Psychiatry. Published online July 20, 2016. doi:10.1001/jamapsychiatry.2016.1390. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact study corresponding author Anna Lembke, M.D., call Tracie White at 650- 723-7628 or email traciew@stanford.edu

The JAMA Network Journals

Related Medicare Articles:

Study: Medicare could overpay medicare advantage plans by $200 billion over ten years
Research conducted at University of California San Diego School of Medicine found that current trends in diagnostic coding for patient risk scores will lead to Medicare overpaying Medicare Advantage (MA) plans substantially through 2026-likely to the tune of hundreds of billions of dollars.
10,000 Medicare patients die in the seven days after discharge from the ED
Researchers found that, each year, about 10,000 generally healthy patients die in the seven days after discharge from the ED.
Hospitals in Medicare ACOs reduced readmissions faster
The Accountable Care Organization model of paying for health care appears to help reduce hospital readmissions among Medicare patients discharged to skilled nursing facilities, a new study suggests.
Highest out-of-pocket cancer spending for Medicare patients without supplement
Which Medicare beneficiaries shoulder the highest out-of-pocket costs after a cancer diagnosis?
Medicare's new way of paying hospitals could cause a bundle of problems for some
Hospitals that take care of the oldest, sickest and most complicated patients could suffer financially under the Medicare system's new approach to paying for some types of care, a new study finds.
More Medicare News and Medicare Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...