Evidence map›Paper›PMID 38888865›Full record

ArticleJournal of general internal medicine2024

Association Between Cost-Sharing and Buprenorphine Prescription Abandonment.

Kao-Ping Chua, Rena M Conti, Pooja Lagisetty, Amy S B Bohnert, Usha Nuliyalu, Thuy D Nguyen

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. 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.

Kao-Ping ChuaSusan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA. chuak@med.umich.edu.ORCID 0000-0002-4081-272X
Rena M ContiDepartment of Markets, Public Policy, And Law, Questrom School of Business, Boston University, Boston, MA, USA.
Pooja LagisettyDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Amy S B BohnertDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Usha NuliyaluSusan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.
Thuy D NguyenDepartment of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA.

Funding

Insurance-related barriers to medications for opioid use disorder in private and Medicaid plansR01DA056438 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUA, KAO-PING, NGUYEN, THUY DIEU · 2022 to 2025
$2.5M
Evaluating Policy Interventions to Decrease Excessive and Risky Perioperative Opioid PrescribingR01DA057284 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUA, KAO-PING, WALJEE, JENNIFER FILIP · 2022 to 2025
$2.5M
Using Default Opioid Prescription Settings to Limit Excessive Opioid Prescribing to Adolescents and Young AdultsK08DA048110 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUA, KAO-PING · 2019 to 2023
$983k
NIDA NIH HHS K08 DA048110NIDA NIH HHS K08DA048110-04NIDA NIH HHS R01 DA056438NIDA NIH HHS R01DA056438-01NIDA NIH HHS R01 DA057284NIDA NIH HHS R01DA057284-01
6 · The paper itself

Abstract

backgroundPrior studies suggest cost-sharing decreases buprenorphine dispensing. However, these studies used databases that only report prescriptions filled by patients, not those that were "abandoned." Consequently, the studies could not calculate the probability of buprenorphine prescription abandonment or evaluate whether cost-sharing is associated with abandonment.

objectiveTo evaluate the association between cost-sharing and buprenorphine prescription abandonment.

designCross-sectional analysis of the IQVIA Formulary Impact Analyzer, a pharmacy transaction database representing 63% of U.S. retail pharmacies. The database includes transaction records ("claims") for prescriptions even if they are not filled.

participantsBuprenorphine claims in 2022 among commercially insured and Medicare patients. MAIN MEASURES: We evaluated the association between cost-sharing per 30-day supply and abandonment using logistic regression, controlling for patient characteristics, product type, and buprenorphine use in the prior 180 days. We assessed for effect modification by prior buprenorphine use. KEY

resultsAnalyses included 2,346,994 and 1,242,596 buprenorphine prescription claims for commercially insured and Medicare patients, respectively. Among these claims, mean (SD) cost-sharing per 30-day supply was $28.1 (46.4) and $8.4 (20.2), and 1.5% and 1.2% were abandoned. Each $10 increase in cost-sharing per 30-day supply was associated with a 0.09 (95% CI: 0.09, 0.10) and 0.09 (95% CI: 0.08, 0.10) percentage-point increase in abandonment among commercially insured and Medicare patients. Among commercially insured and Medicare patients without prior buprenorphine use, respectively, a $10 increase in cost-sharing per 30-day supply was associated with a 0.12 (95% CI: 0.11, 0.14) and 0.13 (95% CI: 0.07, 0.18) percentage-point higher increase in the probability of abandonment compared with patients with > 90 days of prior buprenorphine use.

conclusionsAmong commercially insured and Medicare patients, buprenorphine prescription abandonment is rare and only minimally associated with cost-sharing. Findings suggest elimination of buprenorphine cost-sharing should only be one component of a larger, multi-faceted campaign to increase buprenorphine dispensing.

Indexed as

BuprenorphineCost SharingAdultAgedAnalgesics, OpioidCross-Sectional StudiesDrug PrescriptionsFemaleHumansMaleMedicareMiddle AgedNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersUnited StatesAnalgesics, OpioidBuprenorphineNarcotic Antagonistsaccessbuprenorphinecost-sharinghealth policyinsurance.opioid use disorder

Identifiers

PMID38888865
PMCPMC11347500

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.