REAL-WORLD TRENDS AND PAYER DIFFERENCES IN BUPRENORPHINE DISPENSING AMONG ADOLESCENTS AND YOUNG ADULTS (AYA) WITH OPIOID USE DISORDER (OUD)
Author(s)
Shifa Taj, PharmD1, Hanna Kim, M.S2, Jinae Lee, PhD, M.S2, Daniel B. Hall, PhD, B.S2, Smita Rawal, PhD, PharmD1;
1University of Georgia College of Pharmacy, Department of Clinical and Administrative Pharmacy, Athens, GA, USA, 2Franklin College of Arts and Sciences, University of Georgia, Athens, GA, USA
1University of Georgia College of Pharmacy, Department of Clinical and Administrative Pharmacy, Athens, GA, USA, 2Franklin College of Arts and Sciences, University of Georgia, Athens, GA, USA
OBJECTIVES: Buprenorphine is a medication for treating opioid use disorder (OUD), but little is known about how often it is dispensed to adolescents and young adults (AYA). Recent changes in insurance coverage and treatment access initiatives may influence dispensing patterns, highlighting the need for updated information for this group. This study assessed real-world buprenorphine dispensing trends among AYA with OUD and compared patterns by payer and sex.
METHODS: We used 2020-2023 Merative Marketscan Commercial and Medicaid claims to identify AYA aged 12-25 years with an OUD (ICD-10-CM F11) and at least 90 days of continuous enrollment before their first buprenorphine fill. Annual dispensing rates per person-year (PPY) were calculated overall and stratified by payer and sex. Out-of-pocket spending was summarized by payer.
RESULTS: Among 55,936 AYA with OUD, 12,915 were dispensed buprenorphine and were continuously enrolled. Dispensing patterns varied substantially by year. From 2020 to 2022, dispensing rates were consistently higher in Medicaid than in commercial plans (2020 RR = 0.67; 2021 RR = 0.79; 2022 RR = 0.87; all p < 0.001). In 2023, commercial dispensing increased sharply (16.38 vs. 5.19 PPY), resulting in a more than threefold higher rate than Medicaid (RR = 3.16; p < 0.001). Dispensing patterns by sex changed over time, with higher rates among females in 2020 to 2022 (RR range 0.89-0.93; all p<0.001), and higher rates among males in 2023 (RR=1.25, p<0.001). Median out-of-pocket costs were higher in commercial plans, at $40 (8.9, 140.0) compared with $0 (0.0, 0.0) in Medicaid.
CONCLUSIONS: Buprenorphine dispensing among AYA remained modest and varied by payer and sex across 2020 to 2023. Future research is needed to identify factorsinfluencing these dispensing patterns
METHODS: We used 2020-2023 Merative Marketscan Commercial and Medicaid claims to identify AYA aged 12-25 years with an OUD (ICD-10-CM F11) and at least 90 days of continuous enrollment before their first buprenorphine fill. Annual dispensing rates per person-year (PPY) were calculated overall and stratified by payer and sex. Out-of-pocket spending was summarized by payer.
RESULTS: Among 55,936 AYA with OUD, 12,915 were dispensed buprenorphine and were continuously enrolled. Dispensing patterns varied substantially by year. From 2020 to 2022, dispensing rates were consistently higher in Medicaid than in commercial plans (2020 RR = 0.67; 2021 RR = 0.79; 2022 RR = 0.87; all p < 0.001). In 2023, commercial dispensing increased sharply (16.38 vs. 5.19 PPY), resulting in a more than threefold higher rate than Medicaid (RR = 3.16; p < 0.001). Dispensing patterns by sex changed over time, with higher rates among females in 2020 to 2022 (RR range 0.89-0.93; all p<0.001), and higher rates among males in 2023 (RR=1.25, p<0.001). Median out-of-pocket costs were higher in commercial plans, at $40 (8.9, 140.0) compared with $0 (0.0, 0.0) in Medicaid.
CONCLUSIONS: Buprenorphine dispensing among AYA remained modest and varied by payer and sex across 2020 to 2023. Future research is needed to identify factorsinfluencing these dispensing patterns
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD150
Topic
Real World Data & Information Systems