CTN-0119: Impact of Social Distancing Measures, Expansion of Telemedicine for Buprenorphine Prescribing, and Health Insurance Payor on Access to Buprenorphine During the COVID-19 Pandemic
Jane Liebschutz, MD, MPH
Lead Investigator
University of Pennsylvania, Pittsburgh
liebschutzjm@upmc.edu
COVID-19-related social distancing has resulted in disruptions in the delivery of health care. Simultaneously, the synergistic epidemic between the opioid overdose crisis and the COVID-19 pandemic has resulted in major regulatory changes to ease access to medications for opioid use disorder (MOUD) via telemedicine. This study seeks to address the priorities of NIDA by analyzing a dataset with >90% of all US prescriptions to examine the time-varying impact of COVID-19-related social distancing, MOUD prescribing guideline changes, and health insurance on access to buprenorphine.
Primary Findings
A total of 31 617 849 prescriptions were included. Total MG BUP dispensed increased at 1 and 26 weeks and then returned to baseline trends at 52 weeks post-initial pandemic period (4.1% [95% CI: 3.7,4.5], 2.1% [1.5,2.6], 0.1% [-0.6,0.9]). Stably-treated patients saw a decrease in 7-, 14-, and 28-day treatment disruptions at 52 weeks post-initial-pandemic period (-21.6% [-25.6,-17.7]; -10.8% [-16.3,-5.3]; -27.3% [-33.0,-21.6]). Men retained an increase in MG BUP compared to women at 52 weeks (0.7% [0.01,1.4] versus -0.6% [-1.5,0.2]). Younger age groups (18–29 years and 30–39 years) had a decrease in MG BUP at 52 weeks compared to expected baseline trend (-16.6 [-24.2, -9.0]; -1.6 [-3.0, -0.1). Patients with Medicaid demonstrated an increase in MG BUP at 52 weeks (8.3% [6.3,10.3]). MG BUP prescribed by APP prescribing increased by over 140000 mg per week prior to the pandemic and continued to increase.
Primary Outcomes Article: Roy PJ, et al. Impact of COVID-19-Related Regulatory Changes on Nationwide Access to Buprenorphine: An Interrupted Time Series Design. Drug and Alcohol Dependence Reports 2023;6:10035. [get article]
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