OOP Costs for Buprenorphine Down, But Could Still Present a Barrier for Some

Although daily out-of-pocket costs for buprenorphine prescriptions for opioid use disorder decreased between 2015 and 2020, they varied by payer and remained high for some patients, according to a study published in JAMA Network Open.

“These daily costs can add to up substantial costs for patients retained on long-term therapy or receiving longer duration prescriptions, such as for a 30-days supply,” wrote corresponding author Andrea E. Strahan, PhD, and coauthors from the Centers for Disease Control and Prevention in Atlanta, Georgia. 

The cross-sectional study used all-payer data for buprenorphine prescriptions for adults dispensed at US retail pharmacies between January 2015 and December 2020. Formulations used to treat pain were not included.

On the whole, mean daily out-of-pocket costs decreased from $4.79 in 2015 to $1.91 in 2020, according to the study. 

Nevertheless, they differed widely by payer. In 2015, mean daily out-of-pocket costs were $0.18 with Medicaid, $4.80 with private and commercial insurance, $9.76 with self-pay, and $8.72 with assistance. In 2020, mean daily out-of-pocket costs were $0.10 with Medicaid, $1.82 with private and commercial insurance, $8.44 with self-pay, and $6.31 with assistance.

Researchers also found that mean daily out-of-pocket costs varied by prescriber location and patient characteristics. Patients in the South (whose daily out-of-pocket costs averaged $2.91), metropolitan counties ($1.93), and aged 35 to 44 years ($2.10) paid the most.

“Public health and insurer strategies aimed at reducing higher patient out-of-pocket costs may address financial barriers and improve buprenorphine treatment retention,” researchers advised. “Future research might continue to examine how cost-sharing may impact MOUD [medication for opioid use disorder] treatment initiation and retention under different payers.”

Reference:
Strahan AE, Desai S, Zhang K, Guy GP Jr. Trends in out-of-pocket costs for and characteristics of pharmacy-dispensed buprenorphine medications for opioid use disorder treatment by type of payer, 2015 to 2020. JAMA Netw Open. Published online February 1, 2023. doi:10.1001/jamanetworkopen.2022.54590