Barriers to Buprenorphine Dispensing by Medicaid-Participating Community Retail Pharmacies Article Swipe
Patricia R. Freeman
,
Lindsey R. Hammerslag
,
Katherine A. Ahrens
,
Michael Sharbaugh
,
Adam J. Gordon
,
Anna E. Austin
,
Julie M. Donohue
,
Lindsay Allen
,
Andrew J. Barnes
,
Jeffery Talbert
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1001/jamahealthforum.2024.1077
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1001/jamahealthforum.2024.1077
Importance Controlled substances have regulatory requirements under the US Federal Controlled Substance Act that must be met before pharmacies can stock and dispense them. However, emerging evidence suggests there are pharmacy-level barriers in access to buprenorphine for treatment for opioid use disorder even among pharmacies that dispense other opioids. Objective To estimate the proportion of Medicaid-participating community retail pharmacies that dispense buprenorphine, out of Medicaid-participating community retail pharmacies that dispense other opioids and assess if the proportion dispensing buprenorphine varies by Medicaid patient volume or rural-urban location. Design, Setting, and Participants This serial cross-sectional study included Medicaid pharmacy claims (2016-2019) data from 6 states (Kentucky, Maine, North Carolina, Pennsylvania, Virginia, West Virginia) participating in the Medicaid Outcomes Distributed Research Network (MODRN). Community retail pharmacies serving Medicaid-enrolled patients were included, mail-order pharmacies were excluded. Analyses were conducted from September 2022 to August 2023. Main Outcomes and Measures The proportion of pharmacies dispensing buprenorphine approved for opioid use disorder among pharmacies dispensing an opioid analgesic or buprenorphine prescription to at least 1 Medicaid enrollee in each state. Pharmacies were categorized by median Medicaid patient volume (by state and year) and rurality (urban vs rural location according to zip code). Results In 2016, 72.0% (95% CI, 70.9%-73.0%) of the 7038 pharmacies that dispensed opioids also dispensed buprenorphine to Medicaid enrollees, increasing to 80.4% (95% CI, 79.5%-81.3%) of 7437 pharmacies in 2019. States varied in the percent of pharmacies dispensing buprenorphine in Medicaid (range, 73.8%-96.4%), with significant differences between several states found in 2019 (χ 2 P < .05), when states were most similar in the percent of pharmacies dispensing buprenorphine. A lower percent of pharmacies with Medicaid patient volume below the median dispensed buprenorphine (69.1% vs 91.7% in 2019), compared with pharmacies with above-median patient volume (χ 2 P < .001). Conclusions and Relevance In this serial cross-sectional study of Medicaid-participating pharmacies, buprenorphine was not accessible in up to 20% of community retail pharmacies, presenting pharmacy-level barriers to patients with Medicaid seeking buprenorphine treatment. That some pharmacies dispensed opioid analgesics but not buprenorphine suggests that factors other than compliance with the Controlled Substance Act influence pharmacy dispensing decisions.
Related Topics
Concepts
Medicaid
Buprenorphine
Pharmacy
Opioid use disorder
Medicine
Family medicine
Medical prescription
Medical emergency
Emergency medicine
Opioid
Nursing
Health care
Internal medicine
Economic growth
Economics
Receptor
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1001/jamahealthforum.2024.1077
- https://jamanetwork.com/journals/jama-health-forum/articlepdf/2818723/freeman_2024_br_240003_1715879807.75791.pdf
- OA Status
- gold
- Cited By
- 10
- References
- 8
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4396988657
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4396988657Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1001/jamahealthforum.2024.1077Digital Object Identifier
- Title
-
Barriers to Buprenorphine Dispensing by Medicaid-Participating Community Retail PharmaciesWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-05-17Full publication date if available
- Authors
-
Patricia R. Freeman, Lindsey R. Hammerslag, Katherine A. Ahrens, Michael Sharbaugh, Adam J. Gordon, Anna E. Austin, Julie M. Donohue, Lindsay Allen, Andrew J. Barnes, Jeffery TalbertList of authors in order
- Landing page
-
https://doi.org/10.1001/jamahealthforum.2024.1077Publisher landing page
- PDF URL
-
https://jamanetwork.com/journals/jama-health-forum/articlepdf/2818723/freeman_2024_br_240003_1715879807.75791.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://jamanetwork.com/journals/jama-health-forum/articlepdf/2818723/freeman_2024_br_240003_1715879807.75791.pdfDirect OA link when available
- Concepts
-
Medicaid, Buprenorphine, Pharmacy, Opioid use disorder, Medicine, Family medicine, Medical prescription, Medical emergency, Emergency medicine, Opioid, Nursing, Health care, Internal medicine, Economic growth, Economics, ReceptorTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
10Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 7, 2024: 3Per-year citation counts (last 5 years)
- References (count)
-
8Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.2019. | 227 |
| abstract_inverted_index.2023. | 141 |
| abstract_inverted_index.72.0% | 200 |
| abstract_inverted_index.80.4% | 219 |
| abstract_inverted_index.91.7% | 284 |
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| abstract_inverted_index..001). | 299 |
| abstract_inverted_index.2019), | 286 |
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| abstract_inverted_index.Maine, | 105 |
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| abstract_inverted_index.assess | 73 |
| abstract_inverted_index.before | 17 |
| abstract_inverted_index.claims | 98 |
| abstract_inverted_index.code). | 196 |
| abstract_inverted_index.median | 179, 279 |
| abstract_inverted_index.opioid | 39, 154, 161, 337 |
| abstract_inverted_index.retail | 57, 66, 122, 321 |
| abstract_inverted_index.serial | 92, 305 |
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| abstract_inverted_index.states | 103, 246, 257 |
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| abstract_inverted_index.Results | 197 |
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| abstract_inverted_index.factors | 344 |
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| abstract_inverted_index.serving | 124 |
| abstract_inverted_index.several | 245 |
| abstract_inverted_index.similar | 260 |
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| abstract_inverted_index.Measures | 145 |
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| abstract_inverted_index.pharmacy | 97, 354 |
| abstract_inverted_index.rurality | 188 |
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| abstract_inverted_index.Community | 121 |
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| abstract_inverted_index.Relevance | 302 |
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| abstract_inverted_index.Substance | 11, 351 |
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| abstract_inverted_index.Virginia, | 109 |
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| abstract_inverted_index.analgesic | 162 |
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| abstract_inverted_index.dispensed | 209, 212, 280, 336 |
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| abstract_inverted_index.included, | 128 |
| abstract_inverted_index.influence | 353 |
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| abstract_inverted_index.(Kentucky, | 104 |
| abstract_inverted_index.Controlled | 1, 10, 350 |
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| abstract_inverted_index.Pharmacies | 175 |
| abstract_inverted_index.accessible | 314 |
| abstract_inverted_index.analgesics | 338 |
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| abstract_inverted_index.decisions. | 356 |
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| abstract_inverted_index.enrollees, | 216 |
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| abstract_inverted_index.mail-order | 129 |
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| abstract_inverted_index.substances | 2 |
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| abstract_inverted_index.79.5%-81.3%) | 222 |
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| institutions_distinct_count | 10 |
| corresponding_institution_ids | https://openalex.org/I143302722 |
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