Assessing Buprenorphine Prescribing Trends in the United States

The increase in opioid-related overdose deaths has led to an increase in prescriptions for therapies to manage opioid use disorder. At this time, buprenorphine/naloxone, methadone, and naltrexone are approved by the US Food and Drug Administration to treat opioid use disorder, with buprenorphine being the most commonly prescribed.¹

Although annual buprenorphine treatment per 1000 population has increased between 2009 and 2018 from 1.97 to 4.43, there is a widening treatment gap for young people aged 15 to 24 years. This gap identifies the importance of improving buprenorphine treatment services for this age group, according to an article published in JAMA.²

To study trends in opioid use disorder prescribing and adherence, the researchers identified buprenorphine prescriptions through the IQVIA Real World Date: Longitudinal Prescription database from 2009 to 2018. Calculated buprenorphine rates were based on the US population; annual rates of filling 1 or more buprenorphine prescriptions per 1000 persons were calculated by age group and sex. New buprenorphine use episodes began on the date of a buprenorphine prescription was filled at the pharmacy, after ≥180 days without a fill, and ended after ≥30 days without buprenorphine supply.

The overall rate of buprenorphine use among individuals aged 15 to 80 years increased from 1.97 in 2009 to 4.43 in 2018. Among individuals aged 35 to 44 years, buprenorphine use was the highest, increasing from 2.41 to 8.34; however, among individuals aged 15 to 24 years, buprenorphine use decreased from 1.76 to 1.40. Between 2009 and 2019, buprenorphine use per 1000 population increased from 2.44 to 5.21 for men and from 1.49 to 3.66 for women.

Approximately 29.3% of buprenorphine use episodes continued for at least 180 days with similar percentages found for men and women (28.6% and 30.2%, respectively). Most new episodes of buprenorphine use included at least 1 prescription for ≥16 mg/day, with little variation between men and women (62.8% and 62.9%, respectively).

“Although buprenorphine use has increased for most age groups, individuals aged 15 to 24 years experienced a decrease in use and low treatment retention, as reflected in a low proportion receiving long prescription episodes,” the authors concluded. “Findings suggest a widening treatment gap for young people and underscore the importance of improving buprenorphine treatment services for this age group.”

References

1. Information about Medication-Assisted Treatment (MAT). US Food and Drug Administration website. https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat. Updated February 14, 2019. Accessed January 28, 2020.

2. Olfson M, Zhang VS, Schoenbaum M, King M. Trends in buprenorphine treatment in the United States, 2009-2018. JAMA. 2020;323(3):276-277.

This article originally appeared on Clinical Advisor