Identifying High Prescribers

Jun 9, 2014
Top 5% of opioid prescribers write 40% of all U.S. narcotic prescriptions.
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  • Pain

According to new research from Express Scripts, 40% of U.S. narcotic prescriptions in 2011-2012 were written by only 5% of opioid prescribers.

Understanding High Prescribers

The study identifies prescribers who prescribe opioids at a much higher rate than peers who are in the same specialty, treat patients of similar age, and practice in the same geographic region.

According to the analysis, high prescribers wrote an average of 3.5 times more opioid prescriptions – 4.6 prescriptions per patient compared to 1.3 in the prescriber’s average peer group. Opioid cost per patient was nearly 5 times higher, per average day of therapy, for patients treated by high prescribers.

Who’s Prescribing Opioids

Internal medicine and family practice are among the specialties with the highest prevalence of high prescribers, even after accounting for the volume of prescribers in these two specialties. Nearly 20% of the high prescribers were only prescribing opioids for a single patient.

While narcotics provide needed pain relief to many patients, high prescribing patterns are a potential area of concern. The findings of this study could indicate the need for better education about prescribing guidelines or tighter controls on narcotic prescribing. Based on our research, any outreach efforts should include not just physicians, but office staff and nurses as well.

America’s Drug Problem

Opioid addiction is a deadly epidemic that claims hundreds of thousands of lives, costs millions in wasted healthcare dollars and results in more than 1.2 million emergency room visits each year.
Of the more than half million prescribers analyzed for this study, only 385 were identified as pain specialists.

Closing Gaps in Care

The rise in opioid abuse-related deaths has coincided with increased prescribing of narcotics. Because nearly all of these prescribers specialize in an area other than pain management, the specialist pharmacists within our neuroscience Therapeutic Resource Center can help assure appropriate use of these potent medications and close critical gaps in care.

Download the abstract: Identifying High Prescribers of Opioids: A Multivariate Outlier Detection Approach 

Download a poster presentation about the study methodology and findings.


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