United States providers increased prescribing of buprenorphine/naloxone

1. This quantitative study found that the number of providers prescribing buprenorphine/naloxone within Medicare Part D increased between 2013 and 2017.

2. Female providers and those in clinical neuroscience specialties were more likely to discontinue prescriptions during that time frame.

Evidence Rating Level: 2 (Good)

The current opioid crisis in the United States (US) is a major problem with high morbidity and mortality. Buprenorphine/naloxone therapy is an effective treatment for opioid use disorder (OUD) that can be prescribed from an office setting. The intent of allowing prescriptions from an office setting was to expand access of the drug to a greater number of individuals. However, prior research suggests that most providers do not prescribe up to their permitted capacity, perhaps due to the complexity of ordering the treatment. It is unclear how much and how continuously buprenorphine/naloxone providers order these medications.

This retrospective quantitative study was an analysis of provider and claims data from the 2013-201 Medicare Part D data collected by the Centers for Medicare and Medicaid Services. Providers were included if they had more than 10 yearly prescription claims for at least 1 specific medication (n=14,133). Participants were excluded if they were located outside the 50 states and District of Columbia. The measured outcome was the number of buprenorphine/naloxone prescriptions for each year.

From the analyses, the research demonstrated that the majority of providers who prescribed buprenorphine/naloxone for OUD treatment continued to do so the next year. However, most providers did not prescribe this treatment to their maximum capacity. Additionally, female providers and those in psychiatry were more likely to discontinue prescriptions. The results of this study should be taken into consideration given the studies limitations, including its reliance on Medicare data; some patients may have had other forms of insurance. Additionally, it was unclear why providers discontinued prescriptions. Despite these limitations, this study furthered our understanding of the providers at the forefront of the opioid crisis.

Click to read the study in Journal of Addiction Medicine

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