The association of Medicare Part D prior authorization for buprenorphine‐naloxone with adherence to opioid use disorder treatment guidelines in the United States

Addiction ◽  
2021 ◽  
Author(s):  
William J. Parish ◽  
Tami L. Mark ◽  
Gary A. Zarkin ◽  
Ellen Weber
Keyword(s):  
United States ◽  
Treatment Guidelines ◽  
Medicare Part D ◽  
The United States ◽  
Opioid Use Disorder ◽  
Medicare Part ◽  
Prior Authorization ◽  
Opioid Use ◽  
Part D ◽  
Disorder Treatment

scholarly journals Early National Dissemination of Abiraterone and Enzalutamide for Advanced Prostate Cancer in Medicare Part D

2017 ◽  
Vol 13 (8) ◽  
pp. e694-e702 ◽  
Author(s):  
Megan E.V. Caram ◽  
Tudor Borza ◽  
Hye-Sung Min ◽  
Jennifer J. Griggs ◽  
David C. Miller ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Regional Variation ◽  
Medicare Part D ◽  
The United States ◽  
Medicare Part ◽  
Castration Resistant Prostate Cancer ◽  
Part D ◽  
Hospital Referral ◽  
Early National

Introduction: Abiraterone and enzalutamide were approved by the Food and Drug Administration in 2011 and 2012 to treat men with metastatic castration-resistant prostate cancer (mCRPC). Most men with mCRPC are > 65 years of age and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D data. Methods: We evaluated the number of prescriptions for abiraterone and enzalutamide by provider specialty and hospital referral region (HRR) using Medicare Part D and Dartmouth Atlas data. We categorized HRRs by abiraterone and enzalutamide prescriptions, adjusted for prostate cancer incidence, and examined factors associated with regional variation using multilevel regression models. Results: Among providers who wrote the majority of prescriptions for abiraterone or enzalutamide in 2013 (n = 2,121), 87.5% were medical oncologists, 3.3% were urologists, and 9.2% were other provider specialties. Among prescribers, approximately 30% were responsible for three quarters of the claims for abiraterone and 20% were responsible for more than half the claims for enzalutamide. Some HRRs demonstrated low-prescribing rates despite average medical oncology and urology physician workforce density. Our multilevel model demonstrated that regional factors potentially influenced variation in care. Conclusion: The majority of prescriptions written for abiraterone and enzalutamide through Medicare Part D in 2013 were written by a minority of providers, with marked regional variation across the United States. Better understanding of the early national dissemination of these effective but expensive drugs can help inform strategies to optimize introduction of new, evidence-based mCRPC treatments.

scholarly journals The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare

2018 ◽  
Vol 10 (1) ◽  
pp. 77-112 ◽  
Author(s):  
Thomas C. Buchmueller ◽  
Colleen Carey
Keyword(s):  
United States ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Medicare Part D ◽  
The United States ◽  
Medicare Part ◽  
Prescription Opioids ◽  
Part D ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs

The misuse of prescription opioids has become a serious epidemic in the United States. In response, states have implemented Prescription Drug Monitoring Programs (PDMPs), which record a patient’s opioid prescribing history. While few providers participated in early systems, states have recently begun to require providers to access the PDMP under certain circumstances. We find that “must access” PDMPs significantly reduce measures of misuse in Medicare Part D. In contrast, we find that PDMPs without such provisions have no effect. We find stronger effects when providers are required to access the PDMP under broad circumstances, not only when they are suspicious. (JEL H75, I11, I12, I18)

scholarly journals Early national dissemination of abiraterone and enzalutamide for advanced prostate cancer in Medicare Part D.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 35-35
Author(s):  
Megan Veresh Caram ◽  
Tudor Borza ◽  
Hye-Sung Min ◽  
Jennifer J. Griggs ◽  
David Christopher Miller ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Regional Variation ◽  
Advanced Prostate Cancer ◽  
Medicare Part D ◽  
The United States ◽  
Medicare Part ◽  
Part D ◽  
Hospital Referral ◽  
Early National

35 Background: Abiraterone and enzalutamide are oral medications approved by the Food & Drug Administration in 2011 and 2012 to treat men with advanced castration-resistant prostate cancer. Most men with advanced prostate cancer are over age 65 and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D data. Methods: We evaluated the number of prescriptions for abiraterone and enzalutamide by provider specialty and hospital referral region (HRR) using Medicare Part D and Dartmouth Atlas data. We categorized HRRs by abiraterone and enzalutamide prescriptions, adjusted for prostate cancer incidence, and examined factors associated with regional variation using multilevel regression models. Results: Among all providers who wrote prescriptions for abiraterone or enzalutamide in 2013 (n=2121), 87.5% were medical oncologists, 3.3% urologists, and 9.2% were listed as other provider specialties. Among those who prescribed either drug, 5% of providers were responsible for 75% of the claims for abiraterone, and 7% were responsible for 75% of the claims for enzalutamide. Some HRRs demonstrated low-prescribing rates despite average medical oncology and urology physician workforce density. Conclusions: The majority of prescriptions written for abiraterone and enzalutamide through Medicare Part D in 2013 were written by a minority of providers with marked regional variation across the United States. Better understanding the early national dissemination of these effective but expensive drugs can help inform strategies to optimize introduction of new, evidence-based advanced prostate cancer treatments.

Spillover of Medicaid Expansion to Prescribing of Opioid Use Disorder Medications in Medicare Part D

2021 ◽  
pp. appi.ps.2020008
Author(s):  
Amanda J. Abraham ◽  
Emily C. Lawler ◽  
Samantha J. Harris ◽  
Grace Bagwell Adams ◽  
W. David Bradford
Keyword(s):  
Medicare Part D ◽  
Opioid Use Disorder ◽  
Medicare Part ◽  
Medicaid Expansion ◽  
Opioid Use ◽  
Part D

scholarly journals Medicare part D prescribing for direct oral anticoagulants in the United States: Cost, use and the “rubber effect”

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198674 ◽  
Author(s):  
Panayiotis D. Ziakas ◽  
Irene S. Kourbeti ◽  
Loukia S. Poulou ◽  
Georgios S. Vlachogeorgos ◽  
Eleftherios Mylonakis
Keyword(s):  
United States ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medicare Part D ◽  
The United States ◽  
Medicare Part ◽  
Part D

scholarly journals County-level access to opioid use disorder medications in medicare Part D (2010-2015)

2019 ◽  
Vol 54 (2) ◽  
pp. 390-398 ◽  
Author(s):  
Amanda J. Abraham ◽  
Grace Bagwell Adams ◽  
Ashley C. Bradford ◽  
William D. Bradford
Keyword(s):  
Medicare Part D ◽  
Opioid Use Disorder ◽  
Medicare Part ◽  
County Level ◽  
Opioid Use ◽  
Part D
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