Premium
Rise and regional disparities in buprenorphine utilization in the United States
Author(s) -
Pashmineh Azar Amir R.,
CruzMullane Alexandra,
Podd Jaclyn C.,
Lam Warren S.,
Kaleem Suhail H.,
Lockard Laura B.,
Mandel Mark R.,
Chung Daniel Y.,
Simoyan Olapeju M.,
Davis Corey S.,
Nichols Stephanie D.,
McCall Kenneth L.,
Piper Brian J.
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4984
Subject(s) - buprenorphine , medicine , medicaid , opioid use disorder , medical prescription , (+) naloxone , distribution (mathematics) , opioid , emergency medicine , pharmacology , receptor , mathematical analysis , health care , mathematics , economics , economic growth
Abstract Purpose Buprenorphine is an opioid partial agonist used to treat opioid use disorder. While several policy changes have attempted to increase buprenorphine availability, access remains well below optimal levels. This study characterized how buprenorphine utilization in the United States has changed over time and whether there are regional disparities in distribution of the medication. Methods The amount of buprenorphine distributed from 2007 to 2017 was obtained from the Drug Enforcement Administration's Automated Reports and Consolidated Ordering System. Data were expressed as the percent change and milligrams per person in each state. The formulations and cost for prescriptions covered by Medicaid (2008 to 2018) were also examined. Results Buprenorphine distributed to pharmacies increased about 7‐fold (476.8 to 3179.9 kg) while the quantities distributed to hospitals grew 5‐fold (18.6 to 97.6 kg) nationally from 2007 to 2017. Buprenorphine distribution per person was almost 20‐fold higher in Vermont (40.4 mg/person) relative to South Dakota (2.1 mg/person). There was a strong association between the number of physicians authorized to prescribe buprenorphine and distribution per state ( r [49] = +0.94, P < .0005). The buprenorphine/naloxone sublingual film (Suboxone) was the predominant formulation (92.6% of 0.31 million Medicaid prescriptions) in 2008 but accounted for less than three‐fifth (57.3% of 6.56 million prescriptions) in 2018. Conclusions Although buprenorphine availability has substantially increased over the last decade, distribution was very nonhomogeneous across the United States.