Medicare drug coverage may increase opioid abuse

A working paper recently published as part of a National Bureau of Economic Research series examines whether the introduction of the Medicare Prescription Drug Benefit Program in 2006 may have contributed to an increase in prescription drug abuse.

The article, written by Rosalie Liccardo Pacula, David Powell and Erin Taylor, said opioid abuse, as measured by deaths involving opioid analgesics and substance abuse treatment admissions, has dramatically increased since 1999. Between 2005 and 2006 there was a 20 percent increase in opioid-related mortality.

In the abstract, the authors question if Part D’s expanded access to prescription drug benefits among the elderly may have played a role in the increase of opioid abuse.

“We find that one particular insurance expansion that focuses exclusively on expansion of prescription drug benefits, i.e. Medicare Part D, has indeed been a significant contributor to the rise in opioid sales and opioid treatment admissions since its implementation in 2006,” the authors said.

However, the authors found opioid abuse rises more for those who are not elderly or disabled.

“In other words, we find evidence of diversion from those with legitimate medical need (i.e. the Medicare population) to other individuals,” they said. “We estimate that an additional 10 percent increase in Medicare Part D enrollment is associated with a 4 percent increase in opioid prescriptions in the state, and an 8 percent increase in opioid treatment admissions.”

The full paper is available at http://www.nber.org/papers/w21072.