Analysis Concludes Medicare Drug Plans Should Eliminate Barriers to Opioid Use Disorder Treatment

Eliminating Medicare Part D coverage restrictions on the medication buprenorphine would immediately improve patients’ access to opioid use disorder treatment, according to a research letter in JAMA. About 300,000, or 12 percent, of Americans diagnosed with opioid use disorder in 2013 were Medicare beneficiaries. Buprenorphine, which may cause less dependence and fewer withdrawal symptoms than other opioids, is often used to treat the disorder. AHRQ-funded researchers who analyzed drug formularies found that Part D coverage for buprenorphine was relatively high. In 2018, generic buprenorphine tablets were covered by all plans. And about three-fourths of plans covered brand-name and generic versions of buprenorphine-naloxone, which is another opioid medication. Access to both brand-name and generic formulations was often delayed, however, by prior authorization requirements. For example, prescriptions for generic buprenorphine tablets, despite having the lowest cost (about $80), required prior authorization by 66 percent of Part D plans. Access the abstract.