Rx up for stimulants and antidepressants, down for opioids, 2019 to 2022

Overall prescription volumes for stimulant and antidepressant medications increased from 2019 to 2022, while prescription volume for opioids decreased, according to a study published online Sept. 13 in JAMA Network Open .

Ashwini Nagappan, from University of California, Los Angeles, and colleagues characterized in-person and telehealth prescribing patterns for stimulants, antidepressants, and opioids from 2019 to 2022. The analysis included quarterly medical and pharmacy claims from the Trilliant Health national all-payer claims database for all 50 states and the District of Columbia.

The researchers found that during the study period, prescriptions filled for stimulants increased by 37.5%, with the proportion prescribed from a telehealth visit growing from 1.4% in 2019 to 38.1% in 2022. While in-person stimulant prescribing rebounded from the pandemic, it remained below the pre-public health emergency average of 97.6%.

Antidepressant prescriptions increased 20.9% during the study, with telehealth's share growing from 1.5% to 31.4%. Opioid prescriptions declined before quarter 2 of 2020 and continued to decrease by 17.2% overall. Most opioid prescriptions were in-person visits, with telehealth prescriptions reaching 24.1% in quarter 2 of 2020 and leveling off at 8.4% in 2022, an increase from 0% in 2019.

Women had a higher rate of telehealth prescribing across all drug types. Rural telehealth prescriptions climbed, but their share of the overall telehealth market decreased over time.

"As telehealth policies continue to evolve post-public health emergency, balancing access to prescriptions with mitigating potential risks, such as misuse, is crucial," the authors write. "Future research should compare telehealth-based and in-person prescribing appropriateness."

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