The opioid prescribing practices of surgeons: A comprehensive review of the 2015 claims to Medicare Part D

BACKGROUND: The Centers for Disease Control and Prevention have declared that the United States is amidst a continuing opioid epidemic, with drug overdose–related death tripling between 1999 and 2014. Among the 47,055 overdose-related deaths that occurred in 2014, 28,647 (60.9%) of them involved an opioid. METHODS: To determine if there are specific trends in opioid prescribing practices of specific groups of surgeons to better describe any regional or subspecialty trends that exist, the Part D Prescriber Public Use File was used to evaluate all prescription drug orders for Medicare beneficiaries with a Part D prescription drug plan for the 2015 calendar year. Only those providers with the specialty description corresponding to a surgical specialty were included in this study, using the provider's Part B claims. RESULTS: A total of 65,277,932 claims made to Part D by 90,253 surgeons in the 2015 service year were analyzed in this study, demonstrating statistically significant differences in the opioid prescribing practices of surgeons from different states, cities, practice settings, and subspecialties (P < .05). During this year, these surgeons' opioid medication claims cost the health care system $133,091,997.81 in drug benefits. CONCLUSION: All health professionals with opiate prescribing privileges are entrusted with and responsible for the use of these medications; therefore, physicians have a crucial role in ensuring safe and effective use of this treatment option and the deterrence of its abuse. This is true in particular for surgeons given the acuity level and context of their practice.