CHARLESTON, W.Va.--A popular painkiller has held onto its top status as the most prescribed drug to West Virginia Medicare Part D patients, according to a recent study.
Hydrocodone-acetaminophen -- better known as Lortab, Lorcet and Vicodin -- is used to relieve pain and reduce fever.
And recently, national and local groups recommended tighter restrictions on the narcotic because of concerns of abuse.
The study, conducted by nonprofit investigative journalism website ProPublica, looked at prescriptions filled by a pharmacy for Medicare enrollees in 2011.
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The study also compared health care providers active in Medicare's prescription drug program. It looked at providers who wrote at least 50 prescriptions for at least one drug, including refills, in the Medicare Part D Program. ProPublica notes the study does not cover enrollees in an office visit or in a hospital.
According to the data, West Virginia doctors wrote 432,540 hydrocodone-acetaminophen prescriptions, compared to 402,159 prescriptions the previous year. Prescriptions cost Medicare $5.5 million.
Michael Goff, administrator with the West Virginia Board of Pharmacy, said he wasn't surprised the narcotic was the most prescribed drug for West Virginia Medicare Part D patients.
Goff explained a wide range of health care providers prescribes hydrocodone, and he said if the drug is taken for a short period of time, the risk for addiction is slim.
According to the U.S. National Library of Medicine's PubMed Health, hydrocodone may become habit-forming if it's taken for a long time.
However, the site says people should not let a fear of dependence keep them from using it if they need it.
"It's a great analgesic," Goff explained. "There are a lot of different pain issues such as kidney stones, pain in general -- it can be a broad-spectrum painkiller. ... For those reasons too, it's abused. It's the best drug you can get, the strongest you can get and get refills for with less doctor visits."
The narcotic once again was the third most popular drug in the nation, representing the same ranking as in 2010. West Virginia ranked 26th in the nation for hydrocodone prescriptions. California was the top for amount of claims, according to the study.
As with the rest of the nation, many of the drugs on West Virginia's top 10 most prescribed dealt with high blood pressure and high cholesterol.
"Because we have so much obesity, we have so much blood pressure and cholesterol problems but who knew there was so much pain," said Dr. Rahul Gupta, executive director of the Kanawha-Charleston Health Department.
Brands vs. generics
The study looked at the popularity of brand name drugs prescribed over generics. According to ProPublica, prices consist of co-payments and amounts reimbursed by Part D. It does not include confidential rebates negotiated with insurers.
Plavix, for example, is the most expensive drug on the list, according to the study, and it ranked ninth most prescribed in West Virginia. The drug, which is used to prevent stroke, heart attack and other heart problems, cost more than the top eight combined, according to the data.
In West Virginia, doctors wrote 186,209 prescriptions but it cost Medicare $43,958,705, according to the study.
The Mountain State didn't rank near the top when it came to drug costs, however. At $630 million, West Virginia was No. 34 in the nation for top drug costs.
Sen. Evan Jenkins, R-Cabell, who also serves as executive director of the West Virginia Medical Association, said sometimes, name-brand drugs are appropriate over generics.
"The idea that a generic in every case is a satisfactory substitute for a brand name is not accurate and so the brand name versus generic is typically questioned or discussed between a patient and a physician, taking into consideration the clinical health care needs of patients as well as the cost of the drug being prescribed," Jenkins explained.
He said health care providers also have to see if there is a therapeutic difference between generics and brand name drugs.
"There has been a lot of effort over the years that has gone into educating and informing both patients and physicians about issues of cost and quality when it comes to what medications are prescribed," he said.
Jenkins said directed consumer advertising also comes into play when patients directly ask for a particular drug.
"There is a lot of information out there and people have ideas on what may or may not work best for them," he said. "Something that is so important is the doctor patient relationship but the more the communication the better."
West Virginia's top drug, meanwhile, was the 27th most expensive drug, according to the study.
Hydrocodone has been popular in other areas too.
According to the West Virginia Board of Pharmacy's Controlled Substance Monitoring Program, hydrocodone was the top at 28.8 percent with alprazolam and oxycodone following behind at 11.5 percent and 10.1 percent, respectively.
The Charleston Daily Mail previously reported on a study by the Center for Investigative Reporting, a national nonprofit journalism organization, which found veterans' hospitals in Beckley and Huntington prescribed hydrocodone, oxycodone, morphine and methadone at some of the highest rates in the nation from 2001 to 2012.
According to data from the Substance Abuse and Mental Health Services Administration, most of the drugs, 54 percent, obtained for non-medical use came from relatives or friends for free. The data tracked drugs obtained for non-medical use among users age 12 and older in 2011.