Demographic and socioeconomic correlates to buprenorphine access in pharmacies

Abstract

Background: Research has focused on buprenorphine prescribing with limited attention to the role of pharmacy access to buprenorphine for opioid use disorder.

Objective: This study examines demographic and socioeconomic correlates to buprenorphine access in Georgia pharmacies.

Methods: A 5-question (12 potential subqueries) telephone administered survey was used to investigate access and stocking patterns of specific dosages and formulations of buprenorphine in Georgia pharmacies (n = 119). Descriptive statistics characterized physician and pharmacy demographics and buprenorphine stocking practices. Correlations between various factors including buprenorphine stocking practices, geographic, and sociodemographic characteristics were identified using nonlinear regression models.

Results: The majority of pharmacies stocked the most commonly prescribed 8/2 mg dosage strength of buprenorphine/naloxone films and tablets (69.0% and 63.0%, respectively). Other strengths were less likely to be readily available. Pharmacies in Suburban Census tracts were 77.0% more likely to stock any type of buprenorphine monotherapy [odds ratio (OR) = 1.77, t = 2.37, P < 0.05] and 58.1% more likely to stock the 8 mg buprenorphine monotherapy formulation [OR = 1.58, t = 2.15, P < 0.05] than Urban tracts. Pharmacies in areas with above-average non-White populations were 29.6% more likely to stock a monotherapy product [OR = 1.30, t = 2.16, P < 0.05], and those in areas with above-average poverty rates were more likely to stock the 8 mg/2 mg buprenorphine/naloxone tablets [OR = 1.04, t = 2.02, P < 0.05]. There were no additional differences across the sample in formulation or dosage strengths. Pharmacists who endorsed challenges dispensing buprenorphine (23.3%) cited issues around insurance coverage, payment difficulty, prior authorization issues, and low stock of specific formulations.

Conclusions: Results suggest that low availability of certain dosages or formulations of buprenorphine in local pharmacies could obstruct access for patients. Future research should address barriers to supplying buprenorphine and collaborative measures between pharmacists and prescribers to improve access.

Figure 1.

Pharmacies stocking buprenorphine products by formulation and dosage strength. This figure displays the percentage of pharmacies that stocked various formulations and dosage strengths of buprenorphine products. “Any Bup” represents any buprenorphine product or dosage, “Bup/Nal Film” represents buprenorphine/naloxone films, “Bup/Nal Tablets” represents buprenorphine/naloxone tablets, and “Bup Tablets” represents buprenorphine monotherapy tablets. Note. This figure displays the percentage of pharmacies that stocked various formulations and dosage strengths of buprenorphine products. “Any Bup” represents any buprenorphine product or dosage, “Bup/Nal Film” represents buprenorphine/naloxone films, “Bup/Nal Tablets” represents buprenorphine/naloxone tablets, and “Bup Tablets” represents buprenorphine monotherapy tablets