Did the 2021 federal change in the practice guidelines for the administration of buprenorphine for treating opioid use disorder increase buprenorphine prescription dispensing in Medicaid population?

Abstract

Background and objectives: In April 2021, the Department of Health and Human Services released new federal practice guidelines and allowed physicians who wish to treat ≤30 patients with opioid use disorder (OUD) to forego the X-waiver training requirement.

Methods: This observational study compared annual number, dose, and spending of buprenorphine OUD treatments dispensed in the Medicaid population in 2021 versus 2020 using the CMS State Drug Utilization Data (n = 50 states plus D.C.).

Results: Compared to 2020, there was a slight decrease (-3.1%) in the annual number of buprenorphine prescriptions dispensed but an increase in total doses (+3.2%) and payment (10.6%) for buprenorphine prescriptions in 2021.

Discussion and conclusions: Decrease in number of buprenorphine prescriptions in Medicaid population was observed in 2021.

Scientific significance: Our findings support the hypothesis generation in which the removal of X-waiver training alone is not adequate to increase prescribing and access to OUD treatment buprenorphine.