Generic Vicodin Was Most Prescribed Medicare Drug of 2013

By Victoria Kim 05/07/15

Some were surprised that an addictive narcotic painkiller topped the list. But not everyone thinks it's a bad thing.

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Generic Vicodin, also known as hydrocodone acetaminophen, was the top drug prescribed to Medicare beneficiaries in 2013, according to recent data released last week on Medicare’s prescription drug program.

The Wall Street Journal reports that overall, more than eight million Medicare beneficiaries were prescribed hydrocodone acetaminophen in 2013. “It’s striking that the drug prescribed to the most beneficiaries is a narcotic painkiller that can be addictive,” Wallid Gellad, associate professor at the University of Pittsburgh School of Medicine told WSJ.

This trend coincides with the prescription drug “epidemic” in the U.S. Nearly two million Americans either abused or were dependent on opioids in 2013, according the Centers for Disease Control and Prevention.

“It raises the question as to whether those doctors are overprescribing,” said Michael Steinman, associate professor at the University of California, San Francisco. Hydrocodone acetaminophen was the second most prescribed drug in the U.S. last year, according to IMS Health.

The data reflect prescriptions under Part D of Medicare, which covers medications beneficiaries get from pharmacies, not those administered in hospitals or doctors’ offices. Over half of the prescriptions came from family practice or internal medicine physicians.

According to WSJ, many of the doctors listed as prescribing the most hydrocodone acetaminophen said they are justified. One example is Laxmaiah Manchikanti and his partner Yogesh Malla, the ninth and tenth top prescribers of the drug by cost who oversee pain clinics in Kentucky and Illinois. Dr. Manchikanti said nearly all of his painkiller patients came to him already dependent on an opioid prescribed by a primary care doctor. He prefers prescribing hydrocodone acetaminophen because it is less addictive and relatively inexpensive compared with many other painkillers. 

Another doctor, who had one of the highest ratios of claims per beneficiary for the drug, said it is used to relieve pain caused by arthritis, cancer, and other conditions for the approximately 500 nursing home residents his practice provides medical care for.

“They’re all institutionalized and have multiple chronic illnesses,” Dr. Brian Powderly of Parkersburg, West Virginia said. “It is considered substandard medical care to leave pain untreated in a long-term medical facility.”

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