In 2017, one-third of Medicare beneficiaries received an opioid prescription, raising concerns about the role of Medicare Part D’s prescription drug coverage in the opioid pandemic.

After Medicare Part D was introduced in 2006, Medicare saw a 29% increase in patients seeking care for pain. However, a study in Health Services Research by department of health care policy research fellow Adrienne Sabety, PhD, associate physician policy researcher at RAND Tisamarie Sherry, PhD, and associate professor of health care policy Nicole Maestas, PhD, shows that there was no increase in diagnosis of pain-related conditions or opioid prescriptions among Medicare beneficiaries after the induction of Medicare Part D.

“While the introduction of Medicare Part D was not associated with increased medical opioid use among older adults, Medicare is inheriting high levels of opioid use from commercial insurers as large numbers of near-elderly adults on opioid therapy age into Medicare,” the researchers say.

Opioid use among the elderly is largely driven by commercially insured adults who transition to  Medicare coverage. The study team suggests screening for potentially inappropriate opioid use among newly eligible Medicare beneficiaries during patients’ initial “Welcome to Medicare” appointments. Providers can then be guided on how to safely wean their patients off of unnecessary opioids as well as connect them to treatment for opioid dependence.

Partnerships between commercial insurers and Medicare are needed to jointly address opioid prescribing and how to achieve safer pain management for patients across their lifespan.