CMS unveils Part D mapping tool to combat opioid epidemic

An online mapping tool that allows users to search Medicare Part D opioid prescription claims on state, county, and zip code levels is now available on the CMS website. The interactive tool, which shows “de-identified” prescriptions—or prescriptions that have been written and then submitted to be filled—is part of a larger initiative launched by CMS and other agencies to address the growing opioid epidemic in the country.

The epidemic

According to CMS, drug overdose deaths have “risen steadily over the past two decades.” In the last 10 years, approximately 145,000 people have died from overdoses and in 2013, prescription opioid pain reliever overdoses alone were the cause of 16,000 deaths. In addition, CMS noted that heroin deaths have also more than doubled between 2010 and 2013. Andy Slavitt, CMS Acting Administrator, described the issue and claimed that the new mapping tool was meant to provide useful information to providers, local health officials, and others who could gain from knowledge about their communities prescribing practices. “The opioid epidemic impacts every state, county, and municipality,” Slavitt said, “To address the epidemic, while ensuring that individuals with pain receive effective treatment, we need accurate timely information about where the problems are and to what extent they exist.”

The data

The CMS tool contains data that allows the user to search opioid prescriptions by number and percentage level at the local level as well as: (1) state averages; (2) national averages; (3) total providers; (4) total opioid claims; and (5) total claims. The data is privacy protected and contains provider information only; beneficiary information is not made available through the tool.

In total, the data set provides a comprehensive picture of the approximately $103 billion in prescription drugs and supplies reimbursed under the Medicare Part D program. From this data, CMS summarized that “of the 1.4 billion total Part D claims per year, there were approximately 80.7 million opioid claims for 116 distinct opioid products contributing to $3.7 billion of the total Part D prescription drug costs.”

Other efforts

Earlier this year, HHS announced its adoption of a new initiative to combat deaths resulting from opioid and heroin overdoses, which involved, in part, actions directed towards lowering the number of prescriptions for opioids (see HHS hoping to reduce opioid addiction with new initiative, Health Law Daily, March 26, 2015). In July, HHS indicated that it would be providing new funding to state and community health centers to increase access to opioid use disorders and abuse services (see Medication-assisted treatment of opioid use disorder gets funding boost, Health Law Daily, July 27, 2015). Overall, the HHS initiative is focused on “three promising areas,” according to the CMS announcement of the mapping tool: (1) providing information on opioid prescription practices; (2) increasing the use of a drug that reverses symptoms of overdoses called naloxone; and (3) using medication-assisted treatment to treat opioid addiction. HHS has also teamed up with the Centers for Disease Control and Prevention (CDC) to develop prescribing guidelines and to aid in the spread of knowledge on the topic.