Medicare Part D beneficiaries at serious risk of opioid misuse or overdose: a closer look
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Data brief
- Contributor(s):
- United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections. issuing body.
- Publication:
- [Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Government Regulation Medicare Part D -- legislation & jurisprudence Naloxone -- supply & distribution Opioid-Related Disorders -- prevention & control United States United States. Department of Health and Human Services
- Genre(s):
- Technical Report
- Abstract:
- Why OIG Did This Review. As the Nation continues to struggle with the opioid crisis, it is vital to gain a deeper understanding of those who are at risk of misuse or overdose. The 2020 COVID-19 pandemic makes the need to look at this population even more pressing. The National Institutes of Health recently issued a warning that individuals with opioid use disorder could be particularly hard hit by COVID-19, as it is a disease that attacks the lungs. Respiratory disease is known to increase the mortality risk among people taking opioids.1 The Office of Inspector General (OIG) has been tracking opioid use in Medicare Part D throughout the opioid crisis.2 OIG identified 71,260 Part D beneficiaries at serious risk of misuse or overdose in 2017; each of these beneficiaries received extreme amounts of opioids or appeared to be doctor shopping. This data brief provides a deeper understanding of these beneficiaries by examining their Medicare claims from 2017 and 2018 and determining the following: their opioid amounts; the extent to which they had opioid overdoses; the extent to which they received naloxone through Medicare Part D; and the extent to which they have a diagnosis of opioid use disorder and received drugs for medication-assisted treatment (MAT drugs) through Part D. This information is critical to helping the Department of Health and Human Services (HHS) target its efforts to combat the opioid crisis. What OIG Found. 1. Most Part D beneficiaries at serious risk of opioid misuse or overdose in 2017 received high amounts of opioids the following year. 2. Fewer beneficiaries at serious risk in 2017 received extreme amounts of opioids or appeared to be doctor shopping the following year. 3. Eleven percent of beneficiaries at serious risk in 2017 had an overdose or adverse effect from an opioid in 2017 or 2018. 4. About one-quarter of beneficiaries at serious risk in 2017 received a prescription through Part D for naloxone, a drug that reverses opioid overdoses. 5. About half of beneficiaries at serious risk in 2017 have been diagnosed with opioid use disorder or other conditions related to the misuse of opioids. 6. Only 7 percent of beneficiaries at serious risk in 2017 who were diagnosed with opioid use disorder received MAT drugs through Part D, possibly because of challenges that beneficiaries have in accessing prescribers.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (24 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918282079206676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918282079206676