Did the 2021 federal change in the practice guidelines for the administration of buprenorphine for treating opioid use disorder increase buprenorphine prescription dispensing in Medicaid population?

BACKGROUND AND

OBJECTIVES

In April 2021, the Department of Health and Human Services released new federal practice guidelines and allowed physicians who wish to treat ≤30 patients with opioid use disorder (OUD) to forego the X-waiver training requirement.

METHODS

This observational study compared annual number, dose, and spending of buprenorphine OUD treatments dispensed in the Medicaid population in 2021 versus 2020 using the CMS State Drug Utilization Data (n = 50 states plus D.C.).

RESULTS

Compared to 2020, there was a slight decrease (-3.1%) in the annual number of buprenorphine prescriptions dispensed but an increase in total doses (+3.2%) and payment (10.6%) for buprenorphine prescriptions in 2021.

DISCUSSION AND

CONCLUSIONS

Decrease in number of buprenorphine prescriptions in Medicaid population was observed in 2021.

SCIENTIFIC SIGNIFICANCE: Our findings support the hypothesis generation in which the removal of X-waiver training alone is not adequate to increase prescribing and access to OUD treatment buprenorphine.