Ten-Year Trends in Potentially Inappropriate Sedative-Hypnotics and Pain Medication Use among Medicare Part D Beneficiaries
Author(s)
Kirti Mirchandani, MSc1, Manvi Sharma, MBA, MS, RPh, PhD1, Rajender Aparasu, PharmD, PhD2;
1Complete HEOR Solutions LLC., Chalfont, PA, USA, 2University of Houston College of Pharmacy, Houston, TX, USA
1Complete HEOR Solutions LLC., Chalfont, PA, USA, 2University of Houston College of Pharmacy, Houston, TX, USA
Presentation Documents
OBJECTIVES: Several sedative-hypnotics and pain medications are classified as potentially inappropriate medications (PIMs) in older adults as per the American Geriatrics Society (AGS) Beers Criteria®. This study examined the multi-year utilization trends of PIMs among Medicare Part D beneficiaries aged ≥ 65 in the United States.
METHODS: This retrospective cross-sectional study utilized data for 2013-2022 from Centers for Medicare and Medicaid Services Medicare Provider Utilization and Payment Data: Part D Prescriber public use files. PIMs utilization, particularly atypical antipsychotics (AAPs), Z-drugs, benzodiazepines, and painkillers (oral Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), meperidine, and skeletal muscle relaxants) were evaluated by examining the number and proportion of beneficiaries and prescribers by region.
RESULTS: During the ten-year study period, the average number of part D claims for sedative-hypnotics and pain medications were 7.28 million and 10.18 million, respectively. Between 2013 and 2022, there was a slight decrease in the number (proportion) of beneficiaries utilizing antipsychotics (7.56 million (5.04%) to 7.03 million (4.72%)), benzodiazepines (5.51 million (19.13%) to 5.39 million (12.51%)), Z-drugs (1.91 million (6.62%) to 1.36 million (3.17%)), meperidine (10,784 (0.04%) to 4,449 (0.01%)). In contrast, there was an increase in the beneficiaries using NSAIDs (6.90 million (23.90%) to 10.52 million (24.40%)) and skeletal muscle relaxants (1.30 million (4.52%) to 2.14 million (4.96%)). Additionally, the number of prescribers for NSAIDs increased from 240,352 to 319,511, and skeletal muscle relaxant prescribers increased from 127,567 to 161,755. The selected PIMs were most frequently prescribed in the Southern region, followed by the Midwest and Northeast.
CONCLUSIONS: Utilization of selected PIMs, such as antipsychotics, among Medicare beneficiaries slightly declined, while NSAIDs and skeletal muscle relaxants for pain management increased between 2013 and 2022. The findings suggest a critical need to optimize PIM use and improve the quality of care in older adults.
METHODS: This retrospective cross-sectional study utilized data for 2013-2022 from Centers for Medicare and Medicaid Services Medicare Provider Utilization and Payment Data: Part D Prescriber public use files. PIMs utilization, particularly atypical antipsychotics (AAPs), Z-drugs, benzodiazepines, and painkillers (oral Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), meperidine, and skeletal muscle relaxants) were evaluated by examining the number and proportion of beneficiaries and prescribers by region.
RESULTS: During the ten-year study period, the average number of part D claims for sedative-hypnotics and pain medications were 7.28 million and 10.18 million, respectively. Between 2013 and 2022, there was a slight decrease in the number (proportion) of beneficiaries utilizing antipsychotics (7.56 million (5.04%) to 7.03 million (4.72%)), benzodiazepines (5.51 million (19.13%) to 5.39 million (12.51%)), Z-drugs (1.91 million (6.62%) to 1.36 million (3.17%)), meperidine (10,784 (0.04%) to 4,449 (0.01%)). In contrast, there was an increase in the beneficiaries using NSAIDs (6.90 million (23.90%) to 10.52 million (24.40%)) and skeletal muscle relaxants (1.30 million (4.52%) to 2.14 million (4.96%)). Additionally, the number of prescribers for NSAIDs increased from 240,352 to 319,511, and skeletal muscle relaxant prescribers increased from 127,567 to 161,755. The selected PIMs were most frequently prescribed in the Southern region, followed by the Midwest and Northeast.
CONCLUSIONS: Utilization of selected PIMs, such as antipsychotics, among Medicare beneficiaries slightly declined, while NSAIDs and skeletal muscle relaxants for pain management increased between 2013 and 2022. The findings suggest a critical need to optimize PIM use and improve the quality of care in older adults.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD62
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Geriatrics