Trends in Buprenorphine to Treat Opioid Use Disorder in California, 2012 to 2018: Medicaid Outpaces the Rest of the State.
Trends in Buprenorphine to Treat Opioid Use Disorder in California, 2012 to 2018: Medicaid Outpaces the Rest of the State.
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DOI：
10.1097/adm.0000000000000768
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发表时间：
2021-09-01
影响因子：
5.5
通讯作者：
Henry, Stephen G.
中科院分区：
文献类型：
--
作者：
Tseregounis, Iraklis Erik;Gasper, James J.;Henry, Stephen G.
阿片类药物使用障碍在美国仍未得到充分治疗。扩大获得治疗的主要机制之一是使用丁丙诺啡。在这项研究中，我们比较了丁丙诺啡的处方趋势，通过医疗补助与其他付款来源支付。从2012年到2018年，加州处方药监测项目和加州卫生保健服务部的综合数据被用来获得全州范围内用于治疗阿片类药物使用障碍的丁丙诺啡的季度处方率。从2012年到2018年，在医疗补助计划中接受丁丙诺啡治疗的个人比例增加了657%（每10,000名医疗补助受益人1.39至10.5人），从2014年开始增加，并持续到2018年。非医疗补助来源的个人处方率增加了93.7%（每10,000人中有6.54人到12.7人），其中大部分增长发生在2014年之前。加州医疗补助计划在丁丙诺啡获得方面取得了相当大的进展，即使在《平价医疗法案》（Affordable Care Act）的扩张停滞之后，获得丁丙诺啡的机会也在稳步增长。相比之下，最近没有医疗补助的个人获得丁丙诺啡的进展并不令人鼓舞，这表明迫切需要改善没有医疗补助的患者获得丁丙诺啡的举措。
Opioid use disorder remains undertreated in the United States. One of the primary mechanisms for expanding access to treatment has been the use of buprenorphine. In this study, we compare prescribing trends of buprenorphine paid through Medicaid versus other payer sources. Combined data from California’s prescription drug monitoring program and California’s Department of Health Care Services was used to obtain statewide quarterly prescription rates for buprenorphine, indicated for the treatment of opioid use disorder, from 2012 to 2018. From 2012 to 2018, the rate of individuals treated with buprenorphine in Medicaid increased by 657% (1.39 to 10.5 Medicaid beneficiaries per 10,000) with increases beginning in 2014 and continuing through 2018. Rate of individual prescribing among non-Medicaid sources increased by 93.7% (6.54 to 12.7 non-Medicaid individuals per 10,000) with most increases occurring prior to 2014. California Medicaid has made considerable gains in buprenorphine access, with access growing steadily even after expansions through the Affordable Care Act plateaued. In contrast, recent gains in buprenorphine access for individuals without Medicaid are uninspiring, indicating that initiatives to improve buprenorphine access to patients without Medicaid are urgently needed.