3744 - Radiation Oncology Drug Prescription Patterns in Medicare Part D

Purpose/Objective(s): Pharmacologic management of symptoms and disease remains a vital component of oncologic care, yet prescribing habits of radiation oncologists remain understudied. This study analyzes 2022 Medicare Part D data with comparisons by radiation oncologist gender.

Materials/Methods: Data were extracted from the 2022 Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File, which contains information on nearly all prescription drug events submitted to the Medicare Part D program in 2022. Drugs were categorized by frequency of claims and total costs, with subgroup analyses by gender. Vaccinations were excluded.

Results: Prescriptions from 3,424 radiation oncologists (726 female, 2,539 male) accounted for ~$70 million in Medicare spending (Table). Tamsulosin was the most frequently prescribed drug (120,981 claims) across all prescribers, though it contributed only $1.9M in spending. Opioids (Hydrocodone/Acetaminophen, Oxycodone) and corticosteroids (Dexamethasone, Mometasone) were consistently among the top medications. Male prescribers had a higher total claim volume, reflecting their larger representation (79%) in the dataset. Bicalutamide and Ciprofloxacin were among the top drugs prescribed by men, while Levothyroxine and Naloxone ranked higher among female prescribers. Hormonal therapies and anti-androgens accounted for a major portion of costs related to male prescribers, including Enzalutamide ($13.7M), Apalutamide ($13.1M), and Relugolix ($7.9M). Among female prescribers, Relugolix ($565K), Insulin ($478K) and Semaglutide ($414K) were the costliest.

Conclusion: While differences exist between male and female prescribing patterns, they may reflect variations in disease sites managed rather than true prescribing differences. The notable costs associated with female prescribers and diabetes medications, including Semaglutide & insulins, raise questions about the growing role of metabolic management in cancer care.

Table 1