Medicare spending on opioids has grown in the last decade, raising concerns about fraud and drug abuse, an inspector general has found.
Spending for Medicare Part D, the program’s prescription drug benefit, has risen by more than $10 billion annually between 2006 and 2015, the Department of Health and Human Services inspector general found in a new report.
In 2015 alone, $4 billion was spent on commonly abused prescription opioids, such as OxyContin, Fentanyl and Oxycodone. That was an increase of 165 percent since 2006, although the number of Medicare patients with Part D grew 76 percent.
Almost one-third of the nation’s 40 million Medicare patients in Part D were prescribed opioids last year, the inspector general found. Patients received an average of five prescriptions during the year for the addictive painkillers.
While spending growth slowed to 4 percent in 2015, “the high level of spending raises concerns about the misuse of these drugs,” the report said.
Opioid and heroin addiction has reached epidemic levels in the U.S., killing 72 Americans every day. Legislation has been passed in both the House and the Senate dealing with various aspects of the issue, but their differences still must be ironed out in a conference committee.
The use of compounded drugs also is a problem for Part D, the inspector general found, as use of the drugs has risen by more than 3,400 percent since 2006.
Compounded drugs, which are drugs tailored to the need of an individual patient, have become increasingly common in fraud and abuse cases over the last decade.
“These trends raise concerns about fraud and abuse and patient safety,” the report said. “These spending trends, coupled with recent fraud cases involving compounded drugs, signal the need for action.”
The Centers for Medicare and Medicaid Services said it has taken steps to address opioid concerns, such as identifying high-risk beneficiaries. However, the Inspector General said CMS needs to do more to combat the rising misuse of compounded drugs.
“CMS also needs to assess the implications of the compounded drug trends identified in this report and take action where needed to protect the integrity of the program.”
