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Financial, Insurance Barriers May Interfere with Buprenorphine Dispensing at Pharmacy
Although 9 out of 10 prescriptions for buprenorphine as a medication for opioid use disorder (MOUD) were dispensed to patients between 2015 and 2022, financial and insurance restrictions appear to deter some patients from filling prescriptions, according to a poster presented at the RX and Illicit Drug Summit in Atlanta, Georgia.
“Opioid use and overdose deaths continue to affect the lives of millions within the United States. MOUD treatment plays an important role in preventing overdose,” John Nguyen, MPH, of IQVIA Government Solutions said in the poster description. “While policy initiatives have been enabled to allow for more prescribing of buprenorphine for MOUD, barriers to access may still exist at the pharmacy.”
The study used IQVIA Longitudinal Access and Adjudication Data to assess 15-day outcomes for prescriptions for buprenorphine for MOUD between 2015 and 2022. Researchers were interested in trends in prescriptions dispensed, reversed, and rejected, as well as the reasons for rejections, over the study period.
In 2022, 91% of prescriptions for buprenorphine for MOUD were filled, according to the poster.
Between 2015 and 2022, the number of dispensed prescriptions increased by about 52%. However, over the same period, claims that ended up reversed/abandoned at the pharmacy increased by 181%. Claims that were rejected increased by 368%, the analysis found.
The most common reason for claim rejection was prior authorization, which in 2022 accounted for nearly a third of rejections. "Addressing this hurdle could help more care-seeking patients start therapy or stay on therapy," Nguyen said in the poster. Closely following prior authorization was "product not covered" (14.7%) and "step edit" (14.7%). Together in 2023, these 3 reasons accounted for 46% of rejections.
“Another common reason included the product not being covered by the patient’s pharmacy benefit,” Nguyen reported, “but this has decreased from a peak of 37% of rejected claims in 2019 to 21% in 2022.”
The study was funded by IQVIA.
Reference
Nguyen, J. Challenges to filling buprenorphine MOUD prescriptions at the pharmacy. Poster presented at RX and Illicit Drug Summit; April 1-4, 2024; Atlanta, Georgia
