Peer comparison letters for high prescribers of quetiapine reduce prescription volume and improve guideline conformity of prescription fills.

Photo credit

What was the challenge?

Antipsychotics such as quetiapine are often prescribed for reasons not supported by clinical evidence, increasing healthcare costs and potentially exposing patients to harms. The Center for Program Integrity (CPI) at the Centers for Medicare and Medicaid Services (CMS) partnered with the Office of Evaluation Sciences (OES) to improve the value and safety of quetiapine prescribing in Medicare Part D.

What was the program change?

CPI and OES sent a series of peer comparison letters to high volume prescribers indicating that their quetiapine prescribing was extremely high relative to their within-state peers and that it was under review.

How did the evaluation work?

CPI and OES randomly assigned high volume prescribers (N = 5,055) to get a treatment or control letter. CPI and OES compared the days of quetiapine supplied by the prescribers and the days of quetiapine received by the prescribers’ baseline patients (N = 89,500) over 9 months.

What was the impact?

Sending peer comparison letters to high volume prescribers of quetiapine reduced prescribing, and did so without any detectable adverse impacts.




Health and Human Services




View Abstract