Use of Buprenorphine for Those with Employer-Sponsored Insurance During the Initial Phase of the COVID-19 Pandemic

Published in: Journal of Substance Abuse Treatment, Volume 129 (October 2021). doi: 10.1016/j.jsat.2021.108384

Posted on RAND.org on October 22, 2021

by Jonathan H. Cantor, Andrew W. Dick, Rebecca Lee Haffajee, Megan F. Pera, Dena M. Bravata, Bradley D. Stein, Christopher M. Whaley

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Objective

To quantify weekly rates of use of buprenorphine for those with employer-based insurance and whether the rate differs based on county-level measures of race, historical fatal drug overdose rate, and COVID-19 case rate.

Methods

We used 2020 pharmaceutical claims for 4.8 million adults from a privately insured population to examine changes in the use of buprenorphine to treat opioid use disorder in 2020 during the onset of the COVID-19 pandemic. We quantified variation by examining changes in use rates across counties based on their fatal drug overdose rate in 2018, number of COVID-19 cases per capita, and percent nonwhite.

Results

Weekly use of buprenorphine was relatively stable between the first week of January (0.6 per 10,000 enrollees, 95%CI = 0.2 to 1.1) and the last week of August (0.8 per 10,000 enrollees, 95%CI = 0.4 to 1.3). We did not find evidence of any consistent change in use of buprenorphine by county-level terciles for COVID-19 rate as of August 31, 2020, age-adjusted fatal drug overdose rate, and percent nonwhite. Use was consistently higher for counties in the highest tercile of county age-adjusted fatal drug overdose rate when compared to counties in the lowest tercile of county age-adjusted fatal drug overdose rate.

Discussion

Our results provide early evidence that new federal- and state-level policies may have steadied the rate of using buprenorphine for those with employer-based insurance during the pandemic.

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