Opioid Prescribing for Hand Surgery: A Medicare Part D Analysis

We aim to characterize recent trends in opioid prescribing for hand surgery and better understand the changes in prescribing practices over the past decade.

The Medicare Part D Prescribers database was used to conduct a retrospective review of opioid prescriptions written by hand surgeons from 2013 to 2022. Outcomes were normalized to per million Medicare part D beneficiaries and subgroup analyses were performed by state and US census region.

A total of 1 056 417 opioid prescriptions written by hand surgeons were identified from 2013 to 2022. The most common type of opioid prescribed was hydrocodone (585 587; 55.4%), followed by oxycodone (259 836; 24.6%) and tramadol (132 693; 12.6%). The states with the highest rates of opioid prescriptions were South Dakota (41 898 claims per million beneficiaries) and South Carolina (40 882). The Southern region accounted for the most opioid prescriptions (373 328 claims per million beneficiaries). The number of opioid prescriptions and mean days supplied decreased over time, mostly after 2016. The number of patients with an opioid prescription fluctuated, increasing from 2013 (1847 patients per million beneficiaries) to 2017 (2125), and then decreasing to a low of 1711 patients per million in 2020, but did not have significant trends over time.

Hand surgeons write a significant number of opioid prescriptions. Although mean days supplied for these prescriptions have generally decreased, the number of patients given opioid prescriptions have continued to fluctuate and are not consistently declining. Opioid stewardship initiatives remain necessary to prevent overprescribing.