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. 2019 Mar;109(3):434-436.
doi: 10.2105/AJPH.2018.304856. Epub 2019 Jan 24.

Impact of Medicaid Restrictions on Availability of Buprenorphine in Addiction Treatment Programs

Christina M Andrews  1 , Amanda J Abraham  1 , Colleen M Grogan  1 , Melissa A Westlake  1 , Harold A Pollack  1 , Peter D Friedmann  1
Affiliations

Impact of Medicaid Restrictions on Availability of Buprenorphine in Addiction Treatment Programs

Christina M Andrews et al. Am J Public Health. 2019 Mar.

Abstract

Objectives: To examine how utilization restrictions on state Medicaid benefits for buprenorphine are related to addiction treatment programs' decision to offer the drug.

Methods: We used data from 2 waves of the National Drug Abuse Treatment System Survey conducted in 2014 and 2017 in the United States to assess the relationship of utilization restrictions to buprenorphine availability.

Results: The proportion of programs offering buprenorphine was 43.2% in states that did not impose any utilization restrictions, 25.5% in states that imposed only annual limits, 17.3% in states that imposed only prior authorization, and 12.8% in states that imposed both. Programs in states requiring prior authorization from Medicaid had substantially lower odds of offering buprenorphine (odds ratio = 0.50; 95% confidence interval = 0.29, 0.87).

Conclusions: Medicaid prior authorization was linked to lower odds of buprenorphine provision among addiction treatment programs. Public Health Implications. State Medicaid prior authorization requirements are linked to reduced odds of buprenorphine provision among addiction treatment programs and may discourage prescribing.

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References

    1. Substance Abuse and Mental Health Services Administration. Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health. 2015. Available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FR.... Accessed July 15, 2018.
    1. Davenport S, Matthews K. Opioid use disorder in the United States: diagnosed prevalence by payer, age, sex, and state. 2018. Available at: http://www.milliman.com/insight/2018/Opioid-use-disorder-in-the-United-S.... Accessed July 15, 2018.
    1. Henry J. Kaiser Family Foundation. Medicaid’s role in addressing the opioid epidemic. 2018. Available at: https://www.kff.org/infographic/medicaids-role-in-addressing-opioid-epid.... Accessed July 15, 2018.
    1. Centers for Disease Control and Prevention. Trends in deaths involving heroin and synthetic opioids excluding methadone, and law enforcement drug product reports, by census region—United States, 2006–2015. MMWR Morb Mortal Wkly Rep. 2017;66(34):897–903. - PMC - PubMed
    1. Manhapra A, Rosenheck R, Fiellin DA. Opioid substitution treatment is linked to reduced risk of death in opioid use disorder. BMJ. 2017;357:j1947. - PMC - PubMed

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