Prior authorization restrictions on medications for opioid use disorder: trends in state laws from 2005 to 2019.
Prior authorization restrictions on medications for opioid use disorder: trends in state laws from 2005 to 2019.
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DOI：
10.1080/07853890.2023.2171107
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发表时间：
2023-12
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
作者：
阿片类药物使用障碍（MOUD）-包括美沙酮，丁丙诺啡和纳洛酮-是阿片类药物使用障碍（OUD）最有效的治疗方法。从历史上看，保险公司要求事先授权MOUD，但事先授权往往是报告的一个关键障碍MOUD处方。一些州已经通过法律禁止MOUD的事先授权要求。我们试图确定州法律中MOUD事先授权禁令的频率，并对禁令类型进行分类。我们使用Westlaw法律的软件中的MOUD相关术语搜索了2005年至2019年期间美国所有州和华盛顿特区的法规和法令。在定性软件中，我们使用模板分析-一种混合演绎/归纳方法对讨论MOUD事先授权的法律进行编码。最后，我们使用编码的法律，以确定频率的国家与事先授权的禁令，包括随着时间的推移变化。在2005年至2015年期间，没有州法律禁止MOUD事先授权，第一次禁止出现在2016年。到2019年，有15个州禁止MOUD事先授权。各国在禁止谅解备忘录事先授权方面的做法差别很大。在2019年，各州对所有保险公司（n = 10个州）的MOUD事先授权禁令比仅适用于医疗补助（n = 7个州）或仅适用于非医疗补助保险公司（n = 1个州）更常见。2019年，一般事先授权禁令（n = 10个州）比仅适用于处方集上的药物的禁令、仅适用于首选药物清单上的药物的禁令、仅适用于治疗前5天的禁令和仅适用于治疗前30天的禁令更常见。在2005年至2015年期间，没有任何州在州法规或法规中禁止MOUD事先授权，2016年只有一个州有这样的禁令。到2019年，有15个州制定了MOUD事先授权禁止法。各国在禁止MOUD事先授权方面的做法差异很大，包括在保险公司类型、禁止期限和适用的药物方面。近年来，有MOUD事先授权法禁止的州的数量有所增加。这些法律可以通过使临床医生更容易开MOUD处方来帮助扩大挽救生命的OUD治疗。
Medications for opioid use disorder (MOUDs) – including methadone, buprenorphine, and naltrexone – are the most effective treatments for opioid use disorder (OUD). Historically, insurers have required prior authorization for MOUD, but prior authorization is often reported as a key barrier to MOUD prescribing. Some states have passed laws prohibiting MOUD prior authorization requirements. We sought to identify the frequency of MOUD prior authorization prohibitions in state laws and to categorize types of prohibitions. We searched for regulations and statutes present in all U.S. states and Washington DC between 2005 and 2019 using MOUD-related terms in Westlaw legal software. In qualitative software, we coded laws discussing MOUD prior authorization using template analysis – a mixed deductive/inductive approach. Finally, we used coded laws to identify frequencies of states with prior authorization prohibitions, including changes over time. No states had laws prohibiting MOUD prior authorization between 2005 and 2015, with the first prohibition appearing in 2016. By 2019, fifteen states had MOUD prior authorization prohibitions. States varied significantly in their approach to prohibiting MOUD prior authorization. In 2019, it was more common for states to have MOUD prior authorization prohibitions applying to all insurers (n = 10 states) than to only Medicaid (n = 7 states) or only non-Medicaid insurers (n = 1 state). In 2019, general prior authorization prohibitions (n = 10 states) were more common than prohibitions only applicable to medications on the formulary, prohibitions only applicable to medications on the preferred drug list, prohibitions only applicable during the first 5 days of treatment, and prohibitions only applicable during the first 30 days of treatment. No states had MOUD prior authorization prohibitions between 2005 and 2015 in state statutes or regulations, and only one state had such a prohibition in 2016. By 2019, fifteen states had an MOUD prior authorization prohibition law. States varied significantly in their approach to prohibiting MOUD prior authorization, including with respect to the insurer type, duration of the prohibition, and applicable medication. The number of states with an MOUD prior authorization law prohibition increased in recent years. Such laws could help expand access to life-saving OUD treatments by making it easier for clinicians to prescribe MOUD.
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DOI：
10.1080/00952990.2021.1903023
发表时间：
2021-07-04
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
Andraka-Christou B;Bouskill K;Haffajee RL;Randall-Kosich O;Golan M;Totaram R;Gordon AJ;Stein BD
通讯作者：
Stein BD
影响因子：
6
作者：
Parish, William J.;Mark, Tami L.;Weber, Ellen
通讯作者：
Weber, Ellen
影响因子：
3.9
作者：
Krawczyk, Noa;Buresh, Megan;Agus, Deborah
通讯作者：
Agus, Deborah
影响因子：
6
作者：
Jones, Christopher M.;McCance-Katz, Elinore F.
通讯作者：
McCance-Katz, Elinore F.
影响因子：
4.2
作者：
Stein BD;Jones CM;Smart R;Sheng F;Sorbero M
通讯作者：
Sorbero M