Top 5 Takeaways

1. High Concentration of Prescriptions: The top 10% of antibiotic prescribers accounted for 41% of all antibiotic prescriptions for Medicare Part D beneficiaries in 2019.
2. Higher Prescribing Rates: Higher-volume prescribers had an antibiotic prescribing rate 60% higher than lower-volume prescribers.
3. Regional Disparities: Nearly half of higher-volume prescribers were located in the South, which also had the highest median prescribing rate.
4. Specialty Variations: Family practice and internal medicine were the most common specialties among higher-volume prescribers, collectively accounting for 22% of the total antibiotic volume.
5. Stewardship Opportunities: Publicly available Medicare Part D data can guide targeted antibiotic stewardship interventions to optimize prescribing practices and reduce antibiotic resistance.

Original Article Author and Citation

Corresponding Author

Katryna A. Gouin, kgouin@cdc.gov

Suggested Citation

Gouin KA, Fleming-Dutra KE, Tsay S, Bizune D, Hicks LA, Kabbani S. Identifying Higher-Volume Antibiotic Outpatient Prescribers Using Publicly Available Medicare Part D Data — United States, 2019. MMWR Morb Mortal Wkly Rep 2022;71:202–205. DOI: http://dx.doi.org/10.15585/mmwr.mm7106a3

Summary

This study analyzed 2019 data from the Centers for Medicare & Medicaid Services (CMS) Part D Prescriber Public Use Files to identify higher-volume antibiotic prescribers. The top 10% of prescribers were responsible for 41% of total antibiotic prescriptions, with a prescribing rate 60% higher than lower-volume prescribers. The findings highlight the potential for targeted antibiotic stewardship interventions using publicly available data to reduce antibiotic resistance and improve patient outcomes.

Methods

The study used the CMS Medicare Part D Prescribers by Provider data set, which includes prescriber-level aggregate counts of outpatient prescription drug events. Higher-volume prescribers were defined as those in the highest 10th percentile of antibiotic volume. The analysis included prescribers who distributed 11 or more antibiotic prescriptions in 2019, excluding those in U.S. territories or overseas military bases. The Wilcoxon rank-sum test was used to compare median prescribing rates among prescribers.

Discussion

The study found that a small proportion of prescribers accounted for a large number of antibiotic prescriptions, indicating significant variability in prescribing practices. This variability presents opportunities for targeted antibiotic stewardship interventions, particularly among higher-volume prescribers. The study also identified regional and specialty-specific variations, suggesting areas for focused improvement efforts.

Conclusion

Publicly available Medicare Part D data can be effectively used to identify higher-volume antibiotic prescribers and guide targeted stewardship interventions. Prioritizing these prescribers for interventions could lead to significant reductions in antibiotic prescribing, thereby limiting the emergence of antibiotic resistance and improving patient outcomes.

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