Forty percent of U.S. narcotic prescriptions in 2011-2012 were written by only five percent of opioid prescribers, according to a study Express Scripts (NASDAQ: ESRX) presented today at AcademyHealth’s annual research meeting.
The study identifies prescribers who prescribe opioids at a much higher rate than peers who are in the same specialty, treat patients of similar age, and practice in the same geographic region. Express Scripts’ multivariate approach to identifying high prescribers is the first of its kind.
According to the analysis, high prescribers wrote an average of 3.5 times more opioid prescriptions — 4.6 prescriptions per patient compared to 1.3 in their peer group. Opioid cost per patient per day of therapy was nearly 5 times higher, on average, for patients treated by high prescribers.
Internal medicine and family practice are among the specialties with the highest prevalence of high prescribers, even after accounting for the volume of prescribers in these two specialties. Nearly 20 percent of the high prescribers were only prescribing opioids to one patient.
“While narcotics provide needed pain relief to many patients, high prescribing patterns are a potential area of concern,” said Glen Stettin, MD, senior vice president of Clinical, Research & New Solutions at Express Scripts. “The findings of this study could indicate the need for better education about prescribing guidelines or tighter controls on narcotic prescribing.”
Opioid addiction is a deadly epidemic that claims hundreds of thousands of lives, costs millions in wasted healthcare dollars and results in more than 1.2 million emergency room visits each year.
This 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.
This research also highlights the value of clinical specialization. Of the more than half million prescribers analyzed for this study, only 385 were identified as pain specialists.
“The rise in opioid abuse-related deaths has coincided with increased prescribing of narcotics,” said Dr. Stettin. “Because nearly all of these prescribers specialize in an area other than pain management, the specialist pharmacists within our neuroscience Therapeutic Resource Center® can help assure appropriate use of these potent medications and close critical gaps in care.”
About Express Scripts
Express Scripts (NASDAQ: ESRX) manages more than a billion prescriptions each year for tens of millions of patients. On behalf of our clients — employers, health plans, unions and government health programs — we make the use of prescription drugs safer and more affordable. Express Scripts uniquely combines three capabilities — behavioral sciences, clinical specialization and actionable data — to create Health Decision Science℠, our innovative approach to help individuals make the best drug choices, pharmacy choices and health choices. Better decisions mean healthier outcomes.
Headquartered in St. Louis, Express Scripts provides integrated pharmacy-benefit management services, including network-pharmacy claims processing, home delivery, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services. The company also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services.