Sunday, February 25

In Spite Of X-Waiver Elimination, Buprenorphine Rx Decline


After the removal of the necessary training needed to recommend buprenorphine for opioid usage condition, prescriptions for the drug decreased the next year, brand-new research study programs. Overall dosages increased as well as Medicaid payments for prescriptions, outcomes of a brand-new research study program.


  • Physicians have actually been permitted to recommend buprenorphine, a partial opioid agonist authorized by the Food and Drug Administration (FDA) to deal with opioid usage condition (OUD), under rigorous standards, consisting of finishing 8 hours of structured education and getting an X‐waiver from the Drug Enforcement Agency.
  • In 2021, the Department of Health and Human Services launched brand-new practice standards permitting doctors to bypass the training requirement, and in 2022, the X-waiver requirement for specialists to recommend medications like buprenorphine was gotten rid of.
  • The retrospective, observational analysis utilized 2020-2021 Centers for Medicare & & Medicaid Services State Drug Utilization Data (CMS SDUD), that includes reports by private US states for covered outpatient drugs paid by state Medicaid firms.
  • Scientist compared the yearly overall number and dosages of given buprenorphine prescriptions and yearly state Medicaid payments for these prescriptions in between 2020 and 2021.


  • The overall variety of buprenorphine prescriptions gave in all states was 5,813,262 in 2020 and 5,635,019 in 2021, a 3.1% reduction.
  • Twenty-four state Medicaid programs (47%) had a lower overall variety of buprenorphine prescriptions gave in 2021 vs 2020. Rhode Island (-70.2%), Hawaii (-70.1%), and Texas (-62.1%) had the greatest percent decline in prescriptions.
  • Dosages of buprenorphine prescriptions gave amounted to 150,969,086 in 2020 and 155,751,403 in 2021, representing a 3.2% boost. Nebraska (+83.8%), South Dakota (+41.1%), and New York (+37.1%) had the greatest percent boost in overall dosages gave.
  • Overall Medicaid payment for buprenorphine prescriptions gave was $1,176,555,134 in 2020 and $1,300,973,311 in 2021, for a 10.6% boost. South Dakota (+147.2%), Nebraska (+88.6%), and New York (+72.6%) had the greatest percent boost in Medicaid payments.


The findings recommend “elimination of X‐waiver training alone is not appropriate to increase recommending and gain access to” to buprenorphine, and the “huge space” in between the variety of clients with OUD and those who really get OUD treatment “requires to be dealt with,” the scientists compose.


The research study was led by Jingjing Qian, PhD, Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, Auburn, Alabama. It was released online December 9, 2023, in the American Journal on Addictions


CMS SDUD might have insufficient or incorrect details on given prescriptions. As the research study duration was throughout the COVID‐19 pandemic, buprenorphine recommending may have been affected by restricted personally access to clinicians. The decrease in the variety of buprenorphine prescriptions might be due to altering structure of prescriptions and not alter in the real variety of clients getting buprenorphine. As buprenorphine prescribing is reasonably made complex at the state level, it might have been impacted by aspects ruled out.

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