TOPLINE:

Prescription claims by nurse practitioners (NPs) and physician associates or assistants (PAs) for psychiatric medications in Medicare Part D showed an upward trend from 2013 to 2022, surpassing those by psychiatrists.

METHODOLOGY:

• Researchers conducted an observational, retrospective cohort study analyzing Medicare Part D claims data and prescriber counts from 2013 to 2022.
• Outcomes included the trends in prescribing medications among psychiatrists, family physicians, internists, PAs, and NPs assessed using pharmacoepidemiologic methods and presented in terms of claim counts, prescriber numbers, and percentage changes.
• Overall, 32,402 psychiatrists submitted more than 36.6 million Medicare Part D claims for various medications in 2022.

TAKEAWAY:

• In 2022, family practice physicians wrote more than 55 million prescriptions, followed by NPs, internists, psychiatrists, and PAs.
• Prescription claims by NPs and PAs (30.8%) surpassed those by psychiatrists (18.0%). Primary care physicians accounted for 51.3% of the total claims in 2022.
• Claims by NPs increased substantially from 8.6% to 24.8%, and those by PAs increased from 2.9% to 6.0% over the study period, whereas claims by psychiatrists and internists decreased.
• Prescriber counts increased from 16.9% to 33.7% for NPs and from 8.7% to 11.9% for PAs from 2013 to 2022.

IN PRACTICE:

“These trends continue across all categories of psychiatric medications amid a shifting landscape of prescribers,” the authors wrote, adding, “the data indicate no signs of slowing from 2013 through 2022, establishing a baseline for future efforts to address staffing issues related to mental health prescribers.”

SOURCE:

The study was led by Roderick S. Hooker, PhD, MBA, PA, Ridgefield, Washington. It was published online on January 30, 2026, in Medical Care.

LIMITATIONS:

The study included prescriptions only from individual providers enrolled in a Part D prescription drug plan, potentially not reflecting complete prescribing patterns. Patients with other types of insurance were not included in the study. Events were only recorded if a prescriber had at least 11 claims for a particular drug in a given year. The list of medications prescribed did not include all drugs; the drugs were assigned to a single therapeutic domain, and these drugs were not matched with actual patient diagnoses.

DISCLOSURES:

No funding information was provided for this study. The authors reported having no relevant conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.