Title

Rise and regional disparities in buprenorphine utilization in the United States.

Authors

Amir R Pashmineh Azar
Alexandra Cruz-Mullane
Jaclyn C Podd
Warren S Lam
Suhail H Kaleem
Laura B Lockard
Mark Mandel MD, Lehigh Valley Health NetworkFollow
Daniel Y Chung
Olapeju M Simoyan
Corey S Davis
Stephanie D Nichols
Kenneth L McCall
Brian J Piper

Publication/Presentation Date

6-1-2020

Abstract

PURPOSE: Buprenorphine is an opioid partial agonist used to treat opioid use disorder. While several policy changes have attempted to increase buprenorphine availability, access remains well below optimal levels. This study characterized how buprenorphine utilization in the United States has changed over time and whether there are regional disparities in distribution of the medication.

METHODS: The amount of buprenorphine distributed from 2007 to 2017 was obtained from the Drug Enforcement Administration's Automated Reports and Consolidated Ordering System. Data were expressed as the percent change and milligrams per person in each state. The formulations and cost for prescriptions covered by Medicaid (2008 to 2018) were also examined.

RESULTS: Buprenorphine distributed to pharmacies increased about 7-fold (476.8 to 3179.9 kg) while the quantities distributed to hospitals grew 5-fold (18.6 to 97.6 kg) nationally from 2007 to 2017. Buprenorphine distribution per person was almost 20-fold higher in Vermont (40.4 mg/person) relative to South Dakota (2.1 mg/person). There was a strong association between the number of physicians authorized to prescribe buprenorphine and distribution per state (r[49] = +0.94, P < .0005). The buprenorphine/naloxone sublingual film (Suboxone) was the predominant formulation (92.6% of 0.31 million Medicaid prescriptions) in 2008 but accounted for less than three-fifth (57.3% of 6.56 million prescriptions) in 2018.

CONCLUSIONS: Although buprenorphine availability has substantially increased over the last decade, distribution was very nonhomogeneous across the United States.

Volume

29

Issue

6

First Page

708

Last Page

715

ISSN

1099-1557

Published In/Presented At

Pashmineh Azar, A. R., Cruz-Mullane, A., Podd, J. C., Lam, W. S., Kaleem, S. H., Lockard, L. B., Mandel, M. R., Chung, D. Y., Simoyan, O. M., Davis, C. S., Nichols, S. D., McCall, K. L., & Piper, B. J. (2020). Rise and regional disparities in buprenorphine utilization in the United States. Pharmacoepidemiology and drug safety, 29(6), 708–715. https://doi.org/10.1002/pds.4984

Disciplines

Medicine and Health Sciences

PubMedID

32173955

Department(s)

Department of Surgery, Department of Surgery Residents, Fellows and Residents

Document Type

Article