ArticleThe International journal on drug policy2025
Retention and dropout from sublingual and extended-release buprenorphine treatment: A comparative analysis of data from a nationally representative sample of commercially-insured people with opioid use disorder in the United States.
Article in The International journal on drug policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The trial behind it
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Who cites it
9 citing papers in PubMed.
- Integrating Methadone Services Into Primary Care in Ukraine: Two-Year Outcomes From a Randomized Trial.Annals of internal medicine · 2026Trial
- Extended-release buprenorphine treatment for opioid use disorder: A mixed-methods study of response and experience.Addiction (Abingdon, England) · 2025Trial
- Medication transitions and predictors of illicit substance use during opioid agonist treatment: a three-year follow-up study.Addiction science & clinical practice · 2026Observational
- Policy changes in opioid agonist therapy and impacts on HIV and hepatitis C prevention in Canadian federal prisons.Lancet regional health. Americas · 2026Article
- Enhancing Compliance Through Local Anesthesia in Extended-Release Buprenorphine Therapy: A Report of Two Cases.Cureus · 2026Article
- Failed transition to buprenorphine extended-release injection from high-dose methadone.The mental health clinician · 2026Article
- Buprenorphine Oral Lyophilisate for Treatment of Opioid Use Disorder: Pharmacology and Clinical Efficacy.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Initiation, retention, and discontinuation of extended-release buprenorphine (BUP-XR) for opioid dependence: A single-arm multi-site trial in Ukraine.The International journal on drug policy · 2026Article
- Outpatient initiation of direct-to-inject buprenorphine.Drug and alcohol dependence · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
aimsMaintenance on medications for opioid use disorder, particularly buprenorphine, is critical for reducing overdose risk and improving health outcomes in the United States. This study evaluates retention and dropout probabilities between sublingual buprenorphine (SL-BUP) and extended-release buprenorphine (XR-BUP) among commercially-insured individuals with opioid use disorder (OUD). DESIGN AND
settingA retrospective cohort study using Meretive™ Markeskan® claims data from 2019 to 2020. A multi-state Markov model assessed transitions between treatment states over 12 months.
participantsThe study included 58,933 individuals aged 18-64 years with OUD, initiating SL-BUP (n = 57,520) or XR-BUP (n = 1,413). XR-BUP patients were divided into XR-BUP only (n = 684; 49 %) and XR-BUP with supplemental SL-BUP (XR-BUP+sSL; n = 729; 51 %). MEASUREMENTS: Primary outcomes included probabilities of remaining in treatment or transitioning between states at 1, 3, 6, and 12 months. The impact of dosage and days of supply on retention was also examined.
resultsThe probability of permanent treatment dropout at 6 months was similar for SL-BUP (38.59 %, 95 % CI: 37.9 %-39.4 %) and XR-BUP (41.3 % 95 %CI: 36.8 %-46.1 %), yet the probability of remaining in treatment was significantly higher for SL-BUP than XR-BUP (49.5 %; 95 %CI: 48.8 %-50.1 % vs. 13.5 % 95 % CI: 10.5 %-16.5 %). The high proportion of individuals initially prescribed XR-BUP later transitioned to SL-BUP. Higher doses and longer days supplied of SL-BUP reduced dropout rates. Among patients receiving ≥16 mg/day and ≥28 days, dropout probabilities were 5.7 % (95 % CI: 5.4 %-6.0 %) at 1 month, 15.4 % (95 % CI: 14.8 %-16.2 %) at 3 months, 28.0 % (95 % CI: 26.9 %-29.2 %) at 6 months, and 47.8 % (95 %CI: 45.2 %-49.5 %) at 12 months. In contrast, patients prescribed <16 mg/day and <28 days had a 46.3 % (95 %CI: 45.0 %-47.6 %) dropout rate by 6 months.
conclusionSL-BUP demonstrates higher retention rates and lower dropout compared to XR-BUP in real-world settings. Optimizing SL-BUP dosing and providing extended supplies can improve retention and reduce treatment discontinuation.
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