Evidence map›Paper›PMID 38678682›Full record

Observational studyDrug and alcohol dependence2024

Growing importance of high-volume buprenorphine prescribers in OUD treatment: 2009-2018.

Megan S Schuler, Andrew W Dick, Adam J Gordon, Brendan Saloner, Rose Kerber, Bradley D Stein

Abstract readObservational Study
In one paragraph

Observational study in Drug and alcohol dependence, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

6 authors.

Megan S SchulerRAND Corporation, 1200 S Hayes St, Arlington, VA 22202, USA. Electronic address: mschuler@rand.org.
Andrew W DickRAND Corporation, 20 Park Plaza #920, Boston, MA 022, USA.
Adam J GordonProgram for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA; Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132, USA.
Brendan SalonerDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
Rose KerberRAND Corporation, 20 Park Plaza #920, Boston, MA 022, USA.
Bradley D SteinRAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA 15213, USA.

Funding

Optimal Methods for Estimating Policy Effect Heterogeneity in Opioid Policy ResearchP50DA046351 · NIDA · RAND CORPORATION · PI Rosanna Smart · 2018 to 2026
$20.8M
Quality of Medication Treatment for Opioid Use Disorder in Medicaid-enrollees: The Effects of State Policies and IntiativesR01DA045800 · NIDA · RAND CORPORATION · PI STEIN, BRADLEY D · 2018 to 2022
$2.9M
NIDA NIH HHS P50 DA046351NIDA NIH HHS R01 DA045800
6 · The paper itself

Abstract

backgroundWe examined the number and characteristics of high-volume buprenorphine prescribers and the nature of their buprenorphine prescribing from 2009 to 2018.

methodsIn this observational cohort study, IQVIA Real World retail pharmacy claims data were used to characterize trends in high-volume buprenorphine prescribers (clinicians with a mean of 30 or more active patients in every month that they were an active prescriber) during 2009-2018. Very high-volume prescribing (mean of 100+ patients per month) was also examined.

resultsOverall, 94,491 clinicians prescribed buprenorphine dispensed during 2009-2018. The proportion of active prescribers meeting high-volume criteria increased from 7.4 % in 2009 to 16.7 % in 2018. High-volume prescribers accounted for 80 % of dispensed buprenorphine prescriptions during 2009-2018; very high-volume prescribers accounted for 26 %. Adult primary care physicians consistently comprised the majority of high-volume prescribers. Addiction specialists were much more likely to be high-volume prescribers compared to other specialties, including psychiatrists and pain specialists. By 2018, the proportion of prescriptions from high-volume prescribers paid by Medicaid had doubled to 40 %, accompanied by a decline in both self-pay and commercial insurance. High-volume prescribers were overwhelmingly concentrated in urban counties with the highest fatal overdose rates. In 2018, the highest density of high-volume prescribers was in New England and the mid-Atlantic region.

conclusionsGrowth in high-volume prescribers outpaced the overall growth in buprenorphine prescribers across 2009-2018. High-volume prescribers play an increasingly central role in providing medication for OUD in the U.S., yet results indicate key regional variation in the availability of high-volume buprenorphine prescribers.

Indexed as

BuprenorphineOpiate Substitution TreatmentOpioid-Related DisordersPractice Patterns, Physicians'AdultAnalgesics, OpioidCohort StudiesDrug PrescriptionsFemaleHumansMaleMiddle AgedNarcotic AntagonistsUnited StatesAnalgesics, OpioidBuprenorphineNarcotic AntagonistsBuprenorphineOpioid use disorderTreatment

Identifiers

PMID38678682
PMCPMC11318254

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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.