The Impact of Prior Authorization on Buprenorphine Dose, Relapse Rates, and Cost for Massachusetts Medicaid Beneficiaries with Opioid Dependence
Health Services ResearchPublished 1 July 2014Open access
Robin E. Clark, Jeffrey D. Baxter, Bruce Barton, Gideon Aweh, Elizabeth O’Connell, William H. Fisher
Citations49
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Prior authorization policies strategically targeted by dose level appear to successfully reduce use of higher than recommended buprenorphine doses, and savings are modest and may be accompanied by brief increases in relapse rates.
Abstract
Prior authorization policies strategically targeted by dose level appear to successfully reduce use of higher than recommended buprenorphine doses. Savings from these policies are modest and may be accompanied by brief increases in relapse rates. Lower doses may decrease diversion of buprenorphine.
Keywords
MedicineEconomics, Econometrics and Finance
Cochrane Database of Systematic ReviewsBuprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
2,250 Citations2014Richard P. Mattick, Courtney Breen +2 more
Buprenorphine maintenance compared to placebo and to methadone maintenance in the management of opioid dependence, including its ability to retain people in treatment, suppress illicit drug use, reduce criminal activity, and mortality is evaluated.
Cochrane Database of Systematic ReviewsMethadone maintenance therapy versus no opioid replacement therapy for opioid dependence
1,620 Citations2009Richard P. Mattick, Courtney Breen +2 more
Methadone is an effective maintenance therapy intervention for the treatment of heroin dependence as it retains patients in treatment and decreases heroin use better than treatments that do not utilise opioid replacement therapy, but does not show a statistically significant superior effect on criminal activity or mortality.
Cochrane Database of Systematic ReviewsConsumer-providers of care for adult clients of statutory mental health services
290 Citations2013Veronica Pitt, Dianne Lowe +5 more
A systematic review of randomised trials assessing the effects of employing consumers ofmental health services as providers of statutory mental health services to clients found that past or present consumers who provided mental health Services did so differently than professionals.
PubMedImproving health-based payment for Medicaid beneficiaries: CDPS.
283 Citations2000Richard Kronick, Todd Gilmer +2 more
The diversity of diagnoses and different burdens of illness among disabled and AFDC Medicaid beneficiaries and the taxonomy and statistical performance of CDPS are compared to other leading diagnostic classification systems and find that the new model performs better in a number of respects.
AddictionThe cost–effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States
131 Citations2001Paul G. Barnett, Gregory S. Zaric +1 more
At a price of $5 or less per dose, buprenorphine maintenance is cost-effective under all scenarios the authors considered, and if a medium to high value is assigned to the years of life lived by injection drug users and those in maintenance therapy.
Drug and Alcohol DependenceDiversion and abuse of buprenorphine: Findings from national surveys of treatment patients and physicians
117 Citations2011Chris‐Ellyn Johanson, Cynthia L. Arfken +2 more
The increases in diversion and abuse measures indicate the need to take active attempts to curb diversion and Abuse as well as continuous monitoring and surveillance of all buprenorphine products, although these increases parallel the increased number of tablets sold.
New England Journal of MedicineMedicaid Prior-Authorization Programs and the Use of Cyclooxygenase-2 Inhibitors
114 Citations2004Michael A. Fischer, Sebastian Schneeweiß +2 more
The use of coxibs and spending on NSAIDs varies widely by state and declined substantially after the implementation of prior-authorization programs, which had important implications for the development of rational drug-reimbursement policies.
Drug and Alcohol DependenceThe impact of buprenorphine on treatment of opioid dependence in a Medicaid population: Recent service utilization trends in the use of buprenorphine and methadone
94 Citations2011Bradley D. Stein, Adam J. Gordon +4 more
Buprenorphine use has increased in recent years, with the greatest use in rural communities and in office based settings, however, the percentage of new opioid dependence treatment episodes involving an opioid agonist is unchanged, suggesting the need for further efforts to increase buprenorphines use among urban populations.
Substance Abuse Treatment Prevention and PolicyState policy influence on the early diffusion of buprenorphine in community treatment programs
88 Citations2008Lori J. Ducharme, Amanda J. Abraham
Health AffairsThe Evidence Doesn’t Justify Steps By State Medicaid Programs To Restrict Opioid Addiction Treatment With Buprenorphine
85 Citations2011Robin E. Clark, Mihail Samnaliev +2 more
Buprenorphine appears to have significantly expanded access to treatment because the drug can be prescribed by a physician and taken at home compared with methadone, which by law must be administered at an approved clinic.
Cochrane Database of Systematic ReviewsTranscranial Doppler sonography for detecting stenosis or occlusion of intracranial arteries in people with acute ischaemic stroke
80 Citations2020A. Mattioni, Silvia Cenciarelli +9 more
To assess the diagnostic accuracy of TCD and TCCD for detecting stenosis and occlusion of intracranial large arteries in people with acute ischaemic stroke, a comprehensive search of major relevant electronic databases from 1982 to 2018 yielded 13,534 articles.
Drug and Alcohol DependenceInability to access buprenorphine treatment as a risk factor for using diverted buprenorphine
71 Citations2012Michelle R. Lofwall, Jennifer R. Havens
Examining frequency and source of and risk factors for diverted buprenorphine use over a 6-month period in an Appalachian community sample of prescription opioid abusers suggests that improving, rather than limiting, access to good quality affordable bupRenorphine treatment may be an effective public health strategy to mitigate bup Renorphine abuse.
Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40.
71 Citations2004Margaret Boone, Nancy J. Brown +4 more
These guidelines address the pharmacology and physiology of opioids, opioid addiction, and treatment with buprenorphine; describe patient assessment and the choice of opioid addiction treatment options; provide detailed treatment protocols for opioid withdrawal and maintenance therapy with buPrenorphines; and include information on the treatment of special populations.
Psychiatric ServicesEffect of Prior Authorization of Second-Generation Antipsychotic Agents on Pharmacy Utilization and Reimbursements
64 Citations2008Michael R. Law, Dennis Ross‐Degnan +1 more
Findings suggest that any cost savings from prior-authorization policies would accrue largely through supplemental rebate agreements with manufacturers, which are likely reduced by the transfer of dually eligible Medicaid enrollees to Medicare Part D plans.
Journal of Addictive DiseasesThe Emerging Buprenorphine Epidemic in the United States
42 Citations2012Eric D. Wish, Erin Artigiani +5 more
There was an increase in the percentage of individuals testing positive for buprenorphine and found that these specimens often contained other drugs, suggesting misuse, and physician education programs should redouble their efforts to teach strategies to deter diversion and misuse of the drug.
Medical CareMedicaid Prior Authorization and Controlled-Release Oxycodone
38 Citations2008Nancy E. Morden, Judy Zerzan +6 more
PA impact varied by state and was less dramatic than previously described Medicaid PA effects, suggesting CR oxycodone is relatively refractory to PA, suggesting effective prescription management strategies are needed.
Psychiatric ServicesAssociation Between Prior Authorization for Medications and Health Service Use by Medicaid Patients With Bipolar Disorder
37 Citations2011Christine Y. Lu, Alyce S. Adams +5 more
The prior-authorization policy was associated with increased medication discontinuation and subsequent changes in health service use by patients with bipolar disorder, and these unintended effects raise concerns about quality of care for a group of vulnerable patients.
Population Health ManagementEconomic Impact of Prior Authorization Policies for Atypical Antipsychotics in the Treatment of Schizophrenia
21 Citations2010Safiya Abouzaid, Eric Jutkowitz +4 more
A decision analytic model was developed to compare the cost of schizophrenia treatment from a Medicaid perspective when a PA policy for AA is in place with the cost of no PA, over a 1-year time horizon anditivity analyses show that small increases in hospitalizations will make PA the more costly option.
Psychiatric ServicesAssociation Between Prior Authorization for Medications and Health Service Use by Medicaid Patients With Bipolar Disorder
8 Citations2011Christine Y. Lu, Alyce S. Adams +5 more
This study examined the association of a prior-authorization policy for atypical antipsychotic and anticonvulsant agents with medication discontinuation and use of health services among patients with bipolar disorder.