Medicare patients rarely prescribed buprenorphine-naloxone
Addiction medicine specialists prescribed the most prescriptions for buprenorphine-naloxone.
HealthDay News — Doctors aren't using one of the most effective weapons at their disposal in battling opioid addiction – buprenorphine-naloxone (Suboxone), according to a research letter published online July 20 in JAMA Psychiatry.
Anna Lembke, MD, and Jonathan H. Chen, MD, PhD, of the Stanford University School of Medicine in Palo Alto, Calif., and colleagues examined 2013 Medicare Part D claims data to assess use of buprenorphine-naloxone.
The investigators identified 6,707 prescribers who had filed 486,099 claims for buprenorphine-naloxone. The prescriptions were written for about 81,000 patients. Those prescribers represented less than 2% of the 381,575 prescribers who had filed more than 56.5 million opioid claims. Specialists in addiction medicine were responsible for the most prescriptions for buprenorphine-naloxone, 98.8 claims per prescriber in 2013. Pain management physicians rarely prescribed buprenorphine-naloxone: fewer than 5 buprenorphine-naloxone prescriptions per doctor in 2013. Family doctors averaged about 7 prescriptions per physician, but averaged 161 opioid prescriptions per physician.
"To combat the current prescription opioid epidemic, integration and promotion of opioid agonist therapy should be encouraged, and not just among addiction medicine specialists, who are far too few to meet the current and projected need," the authors write. "Physicians who prescribe high volumes of opioids and thus already have an established therapeutic alliance and prior experience with opioid prescribing are especially well-situated, with some additional training, to intervene when cases of prescription opioid misuse, overuse, and use disorders arise."
- Lembke A, Chen JH. Use of opioid agonist therapy for Medicare patients in 2013. JAMA Psychiatry. 2016; doi: 10.1001/jamapsychiatry.2016.1390