Pandemic may have led to changes in buprenorphine treatment initiation, retention

While more U.S. patients received buprenorphine for opioid use disorder between March 13 and Dec. 1, 2020, than during the same period in 2019, there were about 17% fewer new prescriptions than expected, a recent study found.

More U.S. patients received buprenorphine treatment in 2020 than 2019, but fewer individuals started treatment, a study found.

Researchers used claims representing about 92% of all prescriptions filled at retail pharmacies in all 50 states and the District of Columbia to look at patterns of buprenorphine prescriptions indicated for treatment of opioid use disorder (e.g., sublingual buprenorphine, buprenorphine/naloxone, and extended-release buprenorphine) during the pandemic. They assessed the number of active, starting, and ending buprenorphine treatment episodes from March 13 to Dec. 1, 2020, and the numbers of such episodes that would have been expected in 2020 based on the growth during the same period in 2019. Results were published Dec. 6 by the Journal of General Internal Medicine.

The number of active buprenorphine episodes increased by 11.1% from March 13, 2019, to March 13, 2020, and by 8.5% from Dec. 1, 2019, to Dec. 1, 2020. Compared to the expected number of active episodes on Dec. 1, 2020 (n=742,308), the observed number of episodes was only 2.3% lower. In contrast, new treatment episodes starting between March 13 and Dec. 1, 2020, were 17.2% lower than expected, based on 2019 patterns. Similarly, the number of episodes that ended between March 13 and Dec. 1, 2020, was 16.0% lower than expected.

Among other limitations, the study observed only buprenorphine prescriptions dispensed at retail pharmacies, the authors noted. They added that they had no information about individuals' clinical status or about more general changes in clinical practice that may have influenced prescribing behaviors.

“Our findings suggest that while policy efforts may have been successful in maintaining existing patients in treatment, that success did not extend to individuals not yet in treatment,” the authors wrote. “Future focused efforts are needed to enhance access to and ongoing engagement in treatment for individuals seeking to start buprenorphine treatment, including expanding low threshold and interim care strategies.”