From the Department of Anesthesiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota.
Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado.
Anesth Analg. 2021 Jun 1;132(6):1748-1755. doi: 10.1213/ANE.0000000000005399.
Pain medicine physicians (PMP) are a group of physicians with background training in various primary specialties with interest and expertise in managing chronic pain disorders. Our objective is to analyze prescription drug (PD) claims from the Medicare Part D program associated with PMP to gain insights into patterns, associated costs, and potential cost savings areas.
The primary data source for Part D claims data is the Centers for Medicare and Medicaid Services (CMS) Chronic Conditions Data Warehouse, which contains Medicare Part D prescription drug events (PDE) records received through the claims submission cutoff date. Only providers with taxonomies of pain management (PM) and interventional pain management (IPM) were included in the study. The analysis of PDE was restricted to drugs with >250 claims. The distribution of claims and costs were analyzed based on drug class and provider specialty. Subsequently, we explored claims and expenses for opioid drug prescriptions in detail. Prescribing characteristics of the top 5% of providers by costs and claims were examined to gain additional insights. The costs and claims were explored for the top 10 drugs prescribed by PMP in 2017.
There were a total of unique 3280 PMP-prescribed drugs with an associated expense of 652 million dollars in the 2017 Medicare Part D program. Prescriptions related to PMP account for a tiny fraction of the program's drug expenditure (0.4%). Opioids, anticonvulsants, and gabapentinoids were associated with the largest number of claims and the largest expenses within this fraction. Among opioid drug prescriptions, brand-named drugs account for a small fraction of claims (8%) compared to generic drugs. However, the expenses associated with brand name drugs were higher than generic drugs. Prescribers in the top 5% by PD costs had a higher number of claims, prescribed a higher proportion of branded medications, and had prescriptions associated with longer day supply compared to an average PMP. There were several opioid medications in the top 10 PD list by cost associated with PMP.
Opioids were the most common medications among Medicare part D claims prescribed by PMP. Only 12% of the total opioid PD claims were by PMP. The top 5% of PMP prescribers had 10 times more claims than the average PMP.
疼痛医学医师（PMP）是一群具有各种初级专业背景的医师，他们对管理慢性疼痛障碍有兴趣和专业知识。我们的目标是分析医疗保险处方药计划（Part D）中与 PMP 相关的处方药（PD）索赔，以深入了解模式、相关成本和潜在的成本节约领域。
Part D 索赔数据的主要数据源是医疗保险和医疗补助服务中心（CMS）慢性病数据仓库，其中包含通过索赔提交截止日期收到的医疗保险 Part D 处方药事件（PDE）记录。只有具有疼痛管理（PM）和介入性疼痛管理（IPM）分类的提供者才包括在研究中。仅对有>250 项索赔的 PDE 进行分析。根据药物类别和提供者专业对索赔和费用进行分析。随后，我们详细探讨了阿片类药物处方的索赔和费用。通过成本和索赔对前 5%的提供者进行分析，以获得更多见解。还检查了按成本和索赔排名前 5%的提供者的处方特征，以获得更多见解。探索了 2017 年 PMP 开处方的前 10 种药物的费用和索赔。
2017 年医疗保险 Part D 计划中，共有 3280 种独特的 PMP 开处方药物，相关费用为 6.52 亿美元。与 PMP 相关的处方仅占该计划药物支出的一小部分（0.4%）。阿片类药物、抗惊厥药和加巴喷丁类药物在该部分中与最多的索赔和最大的费用相关。在阿片类药物处方中，与仿制药相比，品牌药物仅占索赔的一小部分（8%）。然而，品牌药物相关的费用高于仿制药。按 PD 费用排名前 5%的开处方者的索赔数量更多，开处方的品牌药物比例更高，处方的日供应量也更长。在与 PMP 相关的十大 PD 成本药物中，有几种阿片类药物。
阿片类药物是 PMP 开处方的医疗保险 Part D 索赔中最常见的药物。在总阿片类药物 PD 索赔中，仅有 12%是由 PMP 开出的。PMP 前 5%的开处方者的索赔数量是平均 PMP 的 10 倍。
