Evidence map›Paper›PMID 34405345›Full record

ArticleJournal of general internal medicine2022

Impact of High Deductible Health Plans on Continuous Buprenorphine Treatment for Opioid Use Disorder.

Alene Kennedy-Hendricks, Cameron J Schilling, Alisa B Busch, Elizabeth A Stuart, Haiden A Huskamp, Mark K Meiselbach, Colleen L Barry, Matthew D Eisenberg

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alene Kennedy-HendricksDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 408, Baltimore, MD, 21205, USA. alene@jhu.edu.ORCID 0000-0001-5747-0538
Cameron J SchillingDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 408, Baltimore, MD, 21205, USA.
Alisa B BuschDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Elizabeth A StuartJohns Hopkins Center for Mental Health and Addiction Policy, Baltimore, MD, USA.
Haiden A HuskampDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Mark K MeiselbachDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 408, Baltimore, MD, 21205, USA.
Colleen L BarryDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 408, Baltimore, MD, 21205, USA.
Matthew D EisenbergDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 408, Baltimore, MD, 21205, USA.

Funding

TRAINING IN HEALTH SERVICES RESEARCHT32HS000029 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI DY, SYDNEY MORSS · 1987 to 2024
$8.3M
Consumer-Directed Health Plans and Substance Use Disorder TreatmentR01DA044201 · NIDA · JOHNS HOPKINS UNIVERSITY · PI BARRY, COLLEEN L, EISENBERG, MATTHEW · 2018 to 2021
$2.9M
AHRQ HHS T32 HS000029NIDA NIH HHS R01 DA044201NIDA NIH HHS R01DA044201
6 · The paper itself

Abstract

backgroundLong-term, continuous treatment with medication like buprenorphine is the gold standard for opioid use disorder (OUD). As high deductible health plans (HDHPs) become more prevalent in the commercial insurance market, they may pose financial barriers to people with OUD.

objectiveTo estimate the impact of HDHPs on continuity of buprenorphine treatment, concurrent visits for counseling/psychotherapy and OUD-related evaluation and management, and out-of-pocket spending.

designDifference-in-differences analysis comparing trends in outcomes among enrollees whose employers offer an HDHP (treatment group) to enrollees whose employers never offer an HDHP (comparison group).

participantsEnrollees with OUD from a national sample of commercial health insurance plans during 2007-2017 who initiate buprenorphine treatment. MAIN MEASURES: Number of days of continuous buprenorphine treatment; probabilities of continuous buprenorphine treatment ≥30, ≥90, ≥180, and ≥365 days; probability of concurrent (i.e., within the same month) behavioral therapy (i.e., counseling or psychotherapy); probability of concurrent OUD-related evaluation and management visits; proportions of buprenorphine treatment episodes with counseling/psychotherapy and evaluation and management visits; and out-of-pocket (OOP) spending on buprenorphine, behavioral therapy, and evaluation and management visits. KEY

resultsHDHPs were associated with an average increase of $98 (95% CI: $48, $150) on OOP spending on buprenorphine per treatment episode but no change in the number of days of continuous buprenorphine treatment or concurrent use of related services.

conclusionsHDHPs do not reduce continuity of buprenorphine treatment among commercially insured enrollees with OUD but may increase financial burden for this population.

Indexed as

BuprenorphineOpioid-Related DisordersDeductibles and CoinsuranceHealth ExpendituresHumansInsurance, HealthUnited StatesBuprenorphinebuprenorphinefinancinghigh deductible health plansinsuranceopioid use disorder

Identifiers

PMID34405345
PMCPMC8904661

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.