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Report: Top 5% of Opioid Prescribers Write 40% of U.S. Narcotic Prescriptions

Few prescribers are pain specialists

Forty percent of U.S. narcotic prescriptions in 2011–2012 were written by only 5% of opioid prescribers, according to a study presented at AcademyHealth’s annual research meeting, held June 8–10 in San Diego, California.

The study identifies physicians who prescribe opioids at a much higher rate than peers who are in the same specialty, who treat patients of similar age, and who practice in the same geographic region.

According to the analysis, high prescribers wrote an average of 3.5 times more opioid prescriptions — 4.6 prescriptions per patient compared with 1.3 in their peer group. The opioid cost per patient per day of therapy was nearly five times higher, on average, for patients treated by high prescribers.

Internal medicine and family practice were found to be among the specialties with the highest prevalence of high prescribers, even after accounting for the volume of prescribers in these two specialties. Nearly 20% of the high prescribers were prescribing opioids to only one patient.

The new research, when applied to prescriber databases, can help identify potential issues with the prescription of narcotics and can be incorporated into efforts to help plan sponsors fight prescription drug fraud and abuse.

The research also highlights the value of clinical specialization. Of the more than 500,000 prescribers analyzed for this study, only 385 were identified as pain specialists.

Opioid addiction claims hundreds of thousands of lives, costs millions in wasted health care dollars, and results in more than 1.2 million emergency room visits each year.

Source: Express Scripts; June 9, 2014.

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