More than 16,000 Americans die each year from prescription drug overdoses. According to the Centers for Disease Control and Prevention, such deaths have increased more than 300 percent since 1998, while prescribing rates for these drugs quadrupled between 1999 and 2010. Narcotic pain relievers—known as opioids—were involved in 75 percent of the nation’s drug overdoses. Deaths connected to opioid misuse now exceed those from heroin and cocaine combined.
Prescription drug abuse also takes a financial toll, with public and private insurers incurring an estimated $72.5 billion in costs each year because of direct drug costs and medical care that results from the misuse and abuse of opioids and other drugs. In fact, every dollar spent on these prescriptions generates an estimated $41 in related medical claims. Yet health insurers—particularly Medicare and Medicaid—have limited options for curtailing drug overuse and abuse, and physicians and pharmacists have few reliable tools to detect at-risk patients.
The Pew Charitable Trusts recognizes prescription drug abuse as a public health crisis in the United States that must be addressed. Pew’s prescription drug abuse project works to develop and support policies that will help reduce the inappropriate use of prescription drugs while ensuring that patients with legitimate medical needs have access to effective pain management.
Patient Review and Restriction Programs as a Policy Option to Address Polypharmacy and Potentially Inappropriate Opioid Use in Medicare Part D
Cynthia Reilly, director of The Pew Charitable Trust’s prescription drug abuse project, sent a letter Friday, April 10, to the Medicare Payment Advisory Commission (MedPAC) outlining policy options for addressing inappropriate opioid use in Medicare Part D beneficiaries. Read More
Nearly 9 million Medicare Part D beneficiaries—28% of this population—received opioids for pain that was not associated with cancer treatment or hospice care in 2011. Read More
Pew supports the intent of CMS to address prescription drug abuse in the Medicare Part D population through the proposed expansion of the OMS, but we recommend that CMS pursue implementation of patient review and restriction (PRR) programs as a proactive strategy to address opioid abuse. Read More