Coverage of Medications That Treat Opioid Use Disorder and Opioids for Pain Management in Marketplace Plans, 2017
Coverage of Medications That Treat Opioid Use Disorder and Opioids for Pain Management in Marketplace Plans, 2017
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DOI：
10.1097/mlr.0000000000000918
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发表时间：
2018-06-01
期刊：
影响因子：
3
通讯作者：
Busch, Alisa B.
中科院分区：
文献类型：
--
作者：
Huskamp, Haiden A.;Riedel, Lauren E.;Busch, Alisa B.
背景资料：治疗阿片类药物使用障碍（OUD）的有效药物在实践中传播缓慢，保险覆盖范围限制可能是一个重要的障碍。目的：比较2017年健康保险市场交易所提供的计划中用于治疗OUD的药物和通常用于疼痛管理的阿片类药物的覆盖范围。研究设计：我们确定了2017年市场上城市和农村县提供的100个计划样本，按人口加权。我们访问了公开可用的计划覆盖面的信息在healthcare.gov与联邦政府促进交流，国家交流网站为国家为基础的交流，和保险公司websites.Results：约14%的计划不包括任何配方的丁丙诺啡/纳洛酮。与短效阿片类止痛药相比，计划更有可能要求优先用于OUD维持治疗的任何受保的基于办公室的丁丙诺啡或纳洛酮制剂（即丁丙诺啡/纳洛酮、丁丙诺啡植入剂、可注射长效纳洛酮）的事先授权（63.6% vs. 19.4%; P
Background: Efficacious medications to treat opioid use disorders (OUDs) have been slow to diffuse into practice, and insurance coverage limits may be one important barrier.Objectives: To compare coverage for medications used to treat OUDs and opioids commonly prescribed for pain management in plans offered on the 2017 Health Insurance Marketplace exchanges.Research Design: We identified a sample of 100 plans offered in urban and in rural counties on the 2017 Marketplaces, weighting by population. We accessed publicly available plan coverage information on healthcare.gov for states with a federally facilitated exchange, the state exchange website for state-based exchanges, and insurer websites.Results: About 14% of plans do not cover any formulations of buprenorphine/naloxone. Plans were more likely to require prior authorization for any of the covered office-based buprenorphine or naltrexone formulations preferred for maintenance OUD treatment (ie, buprenorphine/naloxone, buprenorphine implants, injectable long-acting naltrexone) than of short-acting opioid pain medications (63.6% vs. 19.4%; P