Background: There is a significant shortage of psychiatrists compared with the demand for their services. We studied Medicare Part D claims of psychiatrists and similar clinician prescribers to identify possible shifts in medication prescribing to address this gap. Objective: This pharmacoepidemiology study aimed to identify prescribing patterns among psychiatrists, family physicians, internists, physician associates/assistants (PAs), and nurse practitioners (NPs), as well as trends. Design: An observational, retrospective cohort study of Medicare Part D claims from 2013 to 2022 was conducted. Psychiatrists’ prescription patterns were compared with those of non-psychiatrists, using the National Provider Identifier (NPI). Diagnosis information was not available in the dataset. Participants: In 2022, more than 32,400 psychiatrists’ prescriptions were submitted for more than 36.6 million Medicare Part D claims for various medications. Main Measures: Prescribers and medication claim counts were analyzed to determine the most commonly prescribed drugs by psychiatrists. Total psychiatrist prescription counts and trends were compared with those of primary care physicians, PAs, and NPs. Key Results: Family practice physicians wrote more than 55 million prescriptions in 2022, nearly twice the number written by psychiatrists. From 2013 to 2022, prescriptions written by PAs and NPs showed a strong upward trend. In 2020, prescription claims by NPs surpassed psychiatrists, and by 2022, they had exceeded those of internal medicine physicians. Conclusions: Claims by NPs increased from 8.6% to 24.8%, whereas psychiatrists’ claims decreased from 24.4% to 18.0%. As of 2023, NPs and PAs comprise a significant portion of the workforce that addresses gaps in mental health medication care for Medicare patients.
Hooker et al. (Thu,) studied this question.