University of Florida
Objective: The Medical Use of Marijuana Act became effective in Florida in 2017, which permitted the purchase and use of medical marijuana as treatment or adjuvant therapy for a series of qualifying conditions. Physicians that complete a required course are eligible to become authorized to order medical marijuana for patients. The purpose of this study was to describe physicians who are authorized to order medical marijuana by specialty, and then compare physician Medicare prescription measures by authorization status.
Methods: The publicly available registry of cannabis-authorized physicians was downloaded from the Florida Department of Health’s Office of Medical Marijuana Use (OMMU). Physician records were linked to the Centers for Medicare and Medicaid Services’ (CMS) Medicare Part D Prescriber Public Use File for the year 2017 by the physician’s National Provider Identifier (NPI). The CMS data were used to identify physician specialty as well as the following prescription measures for average total claims in 2017 to Medicare: opioids, long-acting opioids, and name brand medications. Remaining unlinked physicians from the CMS data were classified as not authorized to order medical marijuana. Proportion of physician specialties meeting each prescription measure were calculated by authorization specialty.
Results: There were a total of 2,274 physicians authorized and 68,932 physicians not authorized to order medical marijuana who had filed at least one Medicare claim in the state of Florida in 2017 (3.19% authorized). The specialties with the highest average opioid claims were Interventional Pain Management (authorized: 3283.53+/-374.03 vs. unauthorized: 2460.77+/-199.02), followed by pain management (authorized: 1748.47+/-286.16 vs. unauthorized: 1728.64+/-185.61), and anesthesiology (authorized: 1470.79+/-364.30 vs. unauthorized: 721.34+/-82.70), and these also represented the specialties with highest average long-acting opioid claims. Authorized physicians specializing in rheumatology (884.33+/-243.92), internal medicine (820.45+/-52.22), and cardiology (600.59+/-139.77) had the highest brand name prescribing, while the following unauthorized physicians had the highest brand name prescribing: endocrinology (1435.96+/-59.19), geriatric medicine (1205.66+/-265.26), and pulmonary disease (832.94+/-63.98),
Conclusion: Physicians authorized to prescribe medical marijuana prescribed, on average, more opioids to Medicare patients than their non-authorized specialist counterparts in Florida, while prescribing fewer brand name medications as compared with non-authorized specialist counterparts.
Co-authors: Amie Goodin1, Joshua Brown1
1University of Florida