Medicaid Coverage of Medications to Treat Alcohol and Opioid Dependence
Medicaid Coverage of Medications to Treat Alcohol and Opioid Dependence
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DOI：
10.1016/j.jsat.2015.04.009
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发表时间：
2015-08-01
影响因子：
3.9
通讯作者：
Richardson, John
中科院分区：
文献类型：
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作者：
Mark, Tami L.;Lubran, Robert;Richardson, John
物质使用障碍影响了12%的医疗补助受益人。处方药的流行以及对酒精和阿片类药物依赖治疗的日益增长的需求使各州重新关注其提供药物使用障碍治疗服务，包括药物。这项研究描述了医疗补助计划如何覆盖这些治疗药物。数据来自2013年医疗补助药房文件，2011年和2012年医疗补助州药物使用记录以及2013年美国成瘾医学协会调查。结果显示，只有13个州的医疗补助计划将所有批准用于酒精和阿片类药物依赖的药物列入其首选药物清单。最常被排除的是缓释纳洛酮（19个项目），阿坎酸（19个项目）和美沙酮（20个项目）。对于丁丙诺啡-纳洛酮组合，48个医疗补助计划需要事先授权，11个计划使用1至3年的终身治疗限制。鉴于物质使用障碍的慢性性质和压倒性的证据支持对许多这些药物的持续覆盖，国家可能要重新审查物质使用障碍的好处。(C)2015 Elsevier Inc. All rights reserved.
Substance use disorders affect 12% of Medicaid beneficiaries. The prescription drug epidemic and growing need for treatment of alcohol and opioid dependence have refocused states' attention on their provision of substance use disorder treatment services, including medications. This study characterized how Medicaid programs cover these treatment medications. Data were from 2013 Medicaid pharmacy documents, 2011 and 2012 Medicaid state drug utilization records, and a 2013 American Society of Addiction Medicine survey. Results showed that only 13 state Medicaid programs included all medications approved for alcohol and opioid dependence on their preferred drug lists. The most commonly excluded were extended-release naltrexone (19 programs), acamprosate (19 programs), and methadone (20 programs). For combined buprenorphine-naloxone, 48 Medicaid programs required prior authorization, and 11 programs used 1- to 3-year lifetime treatment limits. Given the chronic nature of substance use disorders and the overwhelming evidence supporting ongoing coverage for many of these medications, states may want to reexamine substance use disorder benefits. (C) 2015 Elsevier Inc. All rights reserved.