A new study analyzed the opioid use of a random sample of approximately 1.8 million Medicare Part D beneficiaries who had least one prescription for an opioid in 2010. The authors found that about 40 percent of opioid utilizers received opioid prescriptions from multiple providers, and that the number of unique opioid providers was strongly correlated with opioid-related hospital admission rates.
Of the approximately 1.8 million beneficiaries who filled at least one prescription for an opioid, 23.1 percent filled prescriptions from two providers, 9.5 percent from three providers, and 7.9 percent from four or more providers. Of the approximately 1.2 million beneficiaries who filled more than one opioid prescription, 34.6 percent filled prescriptions from two providers, 14.2 percent from three providers, and 11.9 percent from four or more providers.
Among patients using the same quantity of prescribed opioids of over the course of a year, those who had four or more providers had twice the annual rate of opioid-related hospital admission than those with only one provider. Beneficiaries who received opioids from multiple providers were on average likelier to receive more opioid prescriptions per year and concurrent opioid prescriptions. They are also less likely to have a single dominant opioid prescriber. The authors found that among beneficiaries receiving opioid prescriptions from four or more providers, the dominant provider was responsible for less than half of the average total number of opioid prescriptions per beneficiary.
While multiple provider opioid prescribing can be a sign of potential prescription drug abuse, it can also indicate fragmented care, which puts beneficiaries at a greater risk of adverse outcomes. To read more about the study, click here.