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Growing importance of high-volume buprenorphine prescribers in OUD treatment: 2009-2018.
- Source :
-
Drug and alcohol dependence [Drug Alcohol Depend] 2024 Jun 01; Vol. 259, pp. 111290. Date of Electronic Publication: 2024 Apr 16. - Publication Year :
- 2024
-
Abstract
- Background: We examined the number and characteristics of high-volume buprenorphine prescribers and the nature of their buprenorphine prescribing from 2009 to 2018.<br />Methods: In this observational cohort study, IQVIA Real World retail pharmacy claims data were used to characterize trends in high-volume buprenorphine prescribers (clinicians with a mean of 30 or more active patients in every month that they were an active prescriber) during 2009-2018. Very high-volume prescribing (mean of 100+ patients per month) was also examined.<br />Results: Overall, 94,491 clinicians prescribed buprenorphine dispensed during 2009-2018. The proportion of active prescribers meeting high-volume criteria increased from 7.4 % in 2009 to 16.7 % in 2018. High-volume prescribers accounted for 80 % of dispensed buprenorphine prescriptions during 2009-2018; very high-volume prescribers accounted for 26 %. Adult primary care physicians consistently comprised the majority of high-volume prescribers. Addiction specialists were much more likely to be high-volume prescribers compared to other specialties, including psychiatrists and pain specialists. By 2018, the proportion of prescriptions from high-volume prescribers paid by Medicaid had doubled to 40 %, accompanied by a decline in both self-pay and commercial insurance. High-volume prescribers were overwhelmingly concentrated in urban counties with the highest fatal overdose rates. In 2018, the highest density of high-volume prescribers was in New England and the mid-Atlantic region.<br />Conclusions: Growth in high-volume prescribers outpaced the overall growth in buprenorphine prescribers across 2009-2018. High-volume prescribers play an increasingly central role in providing medication for OUD in the U.S., yet results indicate key regional variation in the availability of high-volume buprenorphine prescribers.<br />Competing Interests: Declaration of Competing Interest None<br /> (Copyright © 2024 RAND Corporation. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Adult
Male
Female
Middle Aged
United States
Cohort Studies
Drug Prescriptions statistics & numerical data
Narcotic Antagonists therapeutic use
Analgesics, Opioid therapeutic use
Buprenorphine therapeutic use
Opioid-Related Disorders drug therapy
Opioid-Related Disorders epidemiology
Opiate Substitution Treatment trends
Practice Patterns, Physicians' trends
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0046
- Volume :
- 259
- Database :
- MEDLINE
- Journal :
- Drug and alcohol dependence
- Publication Type :
- Academic Journal
- Accession number :
- 38678682
- Full Text :
- https://doi.org/10.1016/j.drugalcdep.2024.111290