LAUSR

Objectives: (1) To describe dispensing of FDA-approved medications used in medication-assisted treatment (MAT) in Medicare Part D beneficiaries during 2013-2017; (2) to identify yearly dispensing associated with physician assistants (PAs) and nurse practitioners (NPs) during 2013-2017; and (3) to examine how Comprehensive Addiction and Recovery Act (CARA) of 2016 impacted dispensing of medications used in MAT in 2016-2017.Method: Retrospective secondary analysis of the Medicare Provider Utilization and Payment Data: Part D Prescriber datasets during the years 2013-2017. Generalized estimating equations (GEEs) were used to analyze the data.Participants: Providers whose national provider identifier is associated with at least one FDA-approved medication used in MAT during 2013-2017 and paid for by Medicare Part D.Main outcome measure: Per-prescriber population-adjusted number of claims for buprenorphine, buprenorphine/naloxone, and naltrexone.Results: There were 4,657,233 claims for medications used in MAT from 2013 to 2017 (mean = 2,374.48 per 100,000). PAs and NPs combined for 254,543 claims during 2013-2017 (mean = 127.58 per 100,000). In the first full year after CARA, prescriptions for medications used in MAT by PAs and NPs increased a population-adjusted 46.96 percent. In the GEE regression model, there were significantly fewer per-provider claims in the years 2013-2015 (pre-CARA) compared with 2017 (post-CARA) (all p 0.05).Conclusion: The year after CARA was passed, claims for medications used in MAT from PAs and NPs increased.