The opioid crisis remains a significant concern in the United States.
With over 100,000 overdose deaths recorded in 2021, especially prominent among those aged 25-54, there is a pressing need for effective treatment solutions.
A recent study conducted by Vanderbilt University Medical Center (VUMC) provides insight into the challenges faced by those diagnosed with opioid use disorder in accessing and sticking to medication-based treatments.
Only 22% of the 40,000 individuals diagnosed with opioid use disorder consistently used the recommended medication, buprenorphine, for a full year.
For many who discontinued the medication, the average duration was just slightly over a month, which is considerably below the recommended treatment duration.
Senior author Dr. Stephen Patrick emphasizes the effectiveness and safety of medications like buprenorphine in preventing adverse outcomes, including overdose deaths.
However, the nationwide statistics indicate a glaring gap in the number of individuals accessing such treatments and those remaining in care.
The Cost Barrier
A primary factor behind discontinuation is the out-of-pocket cost of medication. The study reveals that a higher initial cost for buprenorphine correlates with a higher likelihood of discontinuing its use.
While the out-of-pocket costs generally decrease over time, those who had to pay between $4.28 and $25 daily had a 34% higher risk of discontinuation compared to those paying $0-$0.71. Some patients even faced expenses as high as $98.
Ashley Leech, Ph.D., the study’s lead author, proposes adding buprenorphine to the Affordable Care Act’s preventive drug list.
This change would mandate private insurance plans to cover the drug without patient cost-sharing, potentially removing a significant barrier to consistent medication use.
Implications and Future Steps
Removing the cost barrier could prove transformative in combating the opioid crisis.
By ensuring more people access and continue their treatment, the nation could significantly reduce the costs related to overdose hospitalizations and other related health care expenditures, which run into billions annually.
VUMC’s research team intends to further study the most vulnerable patient groups to devise strategies ensuring consistent treatment access and adherence over time.
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The study was published in JAMA Internal Medicine.
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