Even as the opioid crisis has surged in the United States, Medicare has increasingly complicated access to scientifically proven treatment for opioid use disorder (OUD).
Addiction to opioids can lead to injection use of drugs like heroin and fentanyl. Sharing unsterilized needles and other injection-drug-use equipment poses a major risk of transmitting hepatitis C virus (HCV) and HIV.
Three therapies known as opioid medication-assisted treatment are approved to treat OUD: methadone, buprenorphine and naltrexone.
Publishing their findings in a research letter in the Journal of the American Medical Association, researchers analyzed information on the pharmaceutical formularies maintained by the Medicare Part D prescription drug plan.
Medicare does not cover methadone, so the investigators focused on coverage of buprenorphine. They found that in 2007, 89 percent of Medicare insurance plans covered buprenorphine without any preauthorization requirement restrictions, which can limit access to medications. This figure plummeted to 35 percent in 2018.
Meanwhile, 93 to 100 percent of Medicare plans covered opioid medications without preauthorization requirements.
“Buprenorphine is a safe and effective treatment that decreases deaths due to opioids and stops heroin and other opioid use. People on buprenorphine are able to get their lives back together,” a coauthor of the letter, Todd Korthuis, MD, MPH, a professor of medicine in the Oregon Health & Science University School of Medicine in Portland Oregon, said in a press release. “Medicare insurance companies are making it increasingly difficult to prescribe buprenorphine while making it easy to prescribe opioid pain medications that contributed to the opioid epidemic.”
To read a press release about the study, click here.
To read the research letter’s abstract, click here.