TOPLINE

Abandonment rates of newly prescribed buprenorphine for opioid use disorder (OUD) nearly doubled from 2020 to 2024, a new study showed. Patients who abandoned prescriptions were more likely to be younger, have commercial insurance, or have higher pharmacy deductibles.

METHODOLOGY

• A retrospective cohort study used two datasets with information on commercial insurance and Medicare Advantage enrollees and individuals receiving care from US healthcare organizations. 
• The 1428 adult participants (mean age, 56.6 years; 50.6% men; 84.0% White individuals) had a first buprenorphine prescription for OUD between 2020 and 2024 and continuous enrollment for at least 180 days before and at least 30 days after the index date. 
• The main outcome was the abandonment of buprenorphine prescription, defined as the lack of dispensing or filling of the first prescription within 30 days of the index date, including those not filled by patients or rejected by insurers or pharmacies. 
• Researchers also compared characteristics among patients with dispensed prescriptions and those with abandoned prescriptions. 

TAKEAWAY

• Overall, 25.8% of patients abandoned their first buprenorphine prescription. Prescription abandonment rates increased from 19% in 2020 to 37% in 2024 (P for trend = .02). 
• Patients with abandoned prescriptions had higher mean pharmacy deductibles than those who filled their prescriptions ($483.80 vs $296.40; P = .006). 
• Patients with commercial insurance had higher abandonment rates than those with Medicare Advantage (51.8% vs 48.2%; P < .001). 
• Patients with abandoned prescriptions were also younger than those without abandonment (mean age, 54.3 years vs 57.4 years; P = .001). 

IN PRACTICE

“Over 1 in 3 patients’ first buprenorphine prescriptions were abandoned in 2024, representing a missed opportunity for treatment initiation and engagement,” the investigators wrote.

“Public health efforts, such as directly dispensing buprenorphine during clinical encounters, strengthening linkage to care, and improving buprenorphine availability in pharmacies, could help reduce barriers to treatment access and reduce overdoses,” they added.

SOURCE

The study was led by Xinyi Jiang, PhD, CDC, Atlanta. It was published online on August 4 as a Research Letter in JAMA Network Open.

LIMITATIONS

The study had limited generalizability beyond the commercial insurance and Medicare Advantage population. Researchers were also unable to distinguish prescriptions not filled by patients from those rejected by insurers or pharmacies, and there was potential misclassification of abandonment among prescriptions paid through cash, assistance programs, or other insurance plans not captured in the linked claims data.

DISCLOSURES

Funding information for the study was not provided. The investigators reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.