Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design
Background: The impact of COVID-19-related healthcare changes on access to buprenorphine (BUP) nationwide in the US is unknown. Methods: We conducted an interrupted time series with the IQVIA LRx database. The study timeline included BUP prescriptions from 52 weeks before (2/23/19–2/21/20) to 52 wee...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Drug and Alcohol Dependence Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772724623000057 |
| _version_ | 1827986926377893888 |
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| author | Payel Jhoom Roy Katherine Callaway Kim Katie Suda Jing Luo Xiaoming Wang Donna Olejniczak Jane M Liebschutz |
| author_facet | Payel Jhoom Roy Katherine Callaway Kim Katie Suda Jing Luo Xiaoming Wang Donna Olejniczak Jane M Liebschutz |
| author_sort | Payel Jhoom Roy |
| collection | DOAJ |
| description | Background: The impact of COVID-19-related healthcare changes on access to buprenorphine (BUP) nationwide in the US is unknown. Methods: We conducted an interrupted time series with the IQVIA LRx database. The study timeline included BUP prescriptions from 52 weeks before (2/23/19–2/21/20) to 52 weeks after (4/4/20–4/2/21) the initial pandemic period (2/22/20–4/3/20). Segmented regression estimated relative changes in total milligrams (MG) of BUP available per week nationwide at 1, 26, and 52 weeks post-initial-pandemic. We evaluated treatment disruptions in previously stable patients, defined as ≥6 months of BUP prescriptions. Results: A total of 31 617 849 prescriptions were included. Total MG BUP dispensed increased at 1 and 26 weeks and then returned to baseline trends at 52 weeks post-initial pandemic period (4.1% [95% CI: 3.7,4.5], 2.1% [1.5,2.6], 0.1% [-0.6,0.9]). Stably-treated patients saw a decrease in 7-, 14-, and 28-day treatment disruptions at 52 weeks post-initial-pandemic period (-21.6% [-25.6,-17.7]; -10.8% [-16.3,-5.3]; -27.3% [-33.0,-21.6]). Men retained an increase in MG BUP compared to women at 52 weeks (0.7% [0.01,1.4] versus -0.6% [-1.5,0.2]). Younger age groups (18–29 years and 30–39 years) had a decrease in MG BUP at 52 weeks compared to expected baseline trend (-16.6 [-24.2, -9.0]; -1.6 [-3.0, -0.1). Patients with Medicaid demonstrated an increase in MG BUP at 52 weeks (8.3% [6.3,10.3]). MG BUP prescribed by APP prescribing increased by over 140 000 mg per week prior to the pandemic and continued to increase. Conclusions: Regulatory changes around buprenorphine prescribing facilitated patient access to buprenorphine during the pandemic. |
| first_indexed | 2024-04-09T23:39:05Z |
| format | Article |
| id | doaj.art-1b65cb8e1b1d4bf592f52f0849029f8c |
| institution | Directory Open Access Journal |
| issn | 2772-7246 |
| language | English |
| last_indexed | 2024-04-09T23:39:05Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj.art-1b65cb8e1b1d4bf592f52f0849029f8c2023-03-19T04:39:02ZengElsevierDrug and Alcohol Dependence Reports2772-72462023-03-016100135Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series designPayel Jhoom Roy0Katherine Callaway Kim1Katie Suda2Jing Luo3Xiaoming Wang4Donna Olejniczak5Jane M Liebschutz6Department of Medicine, UPMC/University of Pittsburgh, Pittsburgh, PA, United States; Corresponding author at: 200 Lothrop St, Pittsburgh, PA 15213, United States.Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh School of Medicine, Pittsburgh, PA, United StatesDepartment of Medicine, UPMC/University of Pittsburgh, Pittsburgh, PA, United States; Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United StatesDepartment of Medicine, UPMC/University of Pittsburgh, Pittsburgh, PA, United StatesNational Institute on Drug Abuse, Bethesda, MD, United StatesDepartment of Medicine, UPMC/University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Medicine, UPMC/University of Pittsburgh, Pittsburgh, PA, United StatesBackground: The impact of COVID-19-related healthcare changes on access to buprenorphine (BUP) nationwide in the US is unknown. Methods: We conducted an interrupted time series with the IQVIA LRx database. The study timeline included BUP prescriptions from 52 weeks before (2/23/19–2/21/20) to 52 weeks after (4/4/20–4/2/21) the initial pandemic period (2/22/20–4/3/20). Segmented regression estimated relative changes in total milligrams (MG) of BUP available per week nationwide at 1, 26, and 52 weeks post-initial-pandemic. We evaluated treatment disruptions in previously stable patients, defined as ≥6 months of BUP prescriptions. Results: A total of 31 617 849 prescriptions were included. Total MG BUP dispensed increased at 1 and 26 weeks and then returned to baseline trends at 52 weeks post-initial pandemic period (4.1% [95% CI: 3.7,4.5], 2.1% [1.5,2.6], 0.1% [-0.6,0.9]). Stably-treated patients saw a decrease in 7-, 14-, and 28-day treatment disruptions at 52 weeks post-initial-pandemic period (-21.6% [-25.6,-17.7]; -10.8% [-16.3,-5.3]; -27.3% [-33.0,-21.6]). Men retained an increase in MG BUP compared to women at 52 weeks (0.7% [0.01,1.4] versus -0.6% [-1.5,0.2]). Younger age groups (18–29 years and 30–39 years) had a decrease in MG BUP at 52 weeks compared to expected baseline trend (-16.6 [-24.2, -9.0]; -1.6 [-3.0, -0.1). Patients with Medicaid demonstrated an increase in MG BUP at 52 weeks (8.3% [6.3,10.3]). MG BUP prescribed by APP prescribing increased by over 140 000 mg per week prior to the pandemic and continued to increase. Conclusions: Regulatory changes around buprenorphine prescribing facilitated patient access to buprenorphine during the pandemic.http://www.sciencedirect.com/science/article/pii/S2772724623000057BuprenorphineCOVID-19Buprenorphine-naloxoneAccessPandemic |
| spellingShingle | Payel Jhoom Roy Katherine Callaway Kim Katie Suda Jing Luo Xiaoming Wang Donna Olejniczak Jane M Liebschutz Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design Drug and Alcohol Dependence Reports Buprenorphine COVID-19 Buprenorphine-naloxone Access Pandemic |
| title | Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design |
| title_full | Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design |
| title_fullStr | Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design |
| title_full_unstemmed | Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design |
| title_short | Impact of COVID-19-related regulatory changes on nationwide access to buprenorphine: An interrupted time series design |
| title_sort | impact of covid 19 related regulatory changes on nationwide access to buprenorphine an interrupted time series design |
| topic | Buprenorphine COVID-19 Buprenorphine-naloxone Access Pandemic |
| url | http://www.sciencedirect.com/science/article/pii/S2772724623000057 |
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