| Title: |
Trends in Access to Medications for Opioid Use Disorder |
| Authors: |
Gupta, Sumedha; James, Aditya; Miles, Jennifer; Samples, Hillary; Crystal, Stephen; Simon, Kosali |
| Contributors: |
Economics, School of Liberal Arts |
| Source: |
PMC |
| Publisher Information: |
American Medical Association |
| Publication Year: |
2025 |
| Collection: |
Indiana University - Purdue University Indianapolis: IUPUI Scholar Works |
| Subject Terms: |
Opioid analgesics; Buprenorphine; Health services accessibility; Medicare; Medicaid; Opiate substitution treatment; Opioid-related disorders |
| Description: |
Importance: Medicaid, the largest payer for medications for opioid use disorder (MOUD), disenrolled more than 19.1 million individuals by March 2024 after the continuous coverage requirement ended in April 2023-a process termed Medicaid unwinding-but the impact on buprenorphine receipt remains unknown. Objective: To assess the association between Medicaid unwinding and dispensing of prescription buprenorphine, overall and by payment sources nationally and by state. Design, setting, and participants: Cross-sectional study of buprenorphine dispensing (age ≥18 years) from April 2020 to March 2024 using the IQVIA Longitudinal Prescription (LRx) database containing more than 90% of US retail pharmacy claims. Interrupted time-series estimated levels and trends of buprenorphine prescription dispensation before and after Medicaid unwinding. Main outcomes and measures: The number of patients with filled buprenorphine prescriptions each month was analyzed by payer type (Medicaid, Medicare, commercial, or self-pay) and by state. Stratified analyses assessed state factors, including automated (ex parte) Medicaid renewal rates (higher or lower than the median), income verification sources used for automated renewals (≤3, 4-5, or 6-7), and Affordable Care Act Medicaid expansion status. Results: Of the 2 405 970 adults who filled buprenorphine prescriptions between April 2020 and March 2024, 1 154 866 (48%) had at least 1 fill covered by Medicaid, 288 716 (12%) by Medicare, 1 106 746 (46%) by commercial insurance, and 264 657 (11%) by self-pay. Medicaid unwinding was associated with reversal of previously increasing trends in buprenorphine prescriptions, with 2.9% fewer patients (-23 855 [95% CI, -32 661 to -15 054]) receiving buprenorphine each month by 8 months after unwinding vs the month before unwinding began. This decline was driven by a 12.7% drop in patients with Medicaid-paid fills (-46 545 [95% CI, -51 362 to -41 730]), partially offset by increases in patients with commercial (6.12%, 19 809 [95% CI, 12 109 to 27 ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
JAMA Health Forum; Gupta S, James A, Miles J, Samples H, Crystal S, Simon K. Trends in Access to Medications for Opioid Use Disorder. JAMA Health Forum. 2025;6(4):e250393. Published 2025 Apr 4. doi:10.1001/jamahealthforum.2025.0393; https://hdl.handle.net/1805/48013 |
| Availability: |
https://hdl.handle.net/1805/48013 |
| Rights: |
Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.3A92005D |
| Database: |
BASE |