{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T02:47:01Z","timestamp":1778986021079,"version":"3.51.4"},"reference-count":14,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Buprenorphine has been approved for opioid use disorder treatment, yet remains underutilized. Cost may present a barrier; little is known about how out-of-pocket costs vary.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine if out-of-pocket costs and prescription characteristics for buprenorphine varied by type of payer.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study used all-payer data on retail pharmacy\u2013dispensed buprenorphine prescriptions from January 1, 2015, through December 31, 2020, for adults (aged \u226518 years) in the US, excluding formulations primarily used to treat pain. Data were analyzed from July 2021 to June 2022.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Type of payer (private and commercial, self-pay, Medicaid, Medicare, assistance, and unknown) for dispensed prescription.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>All outcomes are prescription-level. Mean and median daily out-of-pocket costs were calculated overall and by payer type. Prescription characteristics (days supplied, patient age and sex, generic vs name brand formulations, and prescriber\u2019s location) were examined by payer type.<\/jats:p><\/jats:sec>Results<\/jats:title>Although mean daily out-of-pocket costs decreased overall from $4.79 (95% CI, $4.79-$4.80) in 2015 (7\u202f375\u202f508 prescriptions) to $1.91 (95% CI, $1.90-$1.91) in 2020 (13\u202f486\u202f822 prescriptions), out-of-pocket costs continued to vary by payer in 2020. Medicaid had the lowest mean daily out-of-pocket cost across all years\u2014$0.18 (95% CI, $0.18-$0.18) in 2015, and $0.10 (95% CI, $0.10-$0.10) in 2020. Private and commercial paid prescriptions fell from $4.80 (95% CI, $4.79-$4.81) per day in 2015 to $1.82 (95% CI, $1.82-$1.83) in 2020. Self-pay and assistance categories had the highest mean daily out-of-pocket costs across study years ($9.76 [95% CI, $9.74-$9.78] and $8.72 [95% CI, $8.71-$8.73], respectively, in 2015; $8.44 [95% CI, $8.43-$8.46] and $6.31 [95% CI, $6.30-$6.31], respectively, in 2020). Medicaid paid prescriptions had a mean supply of 15.59 days (95% CI, 15.58-15.59 days) and the lowest percentage of generic prescriptions (57.88%; 95% CI, 57.84%-57.92%). Out-of-pocket cost varied by prescriber location and patient characteristics; mean costs were highest for prescriptions written in the South ($2.91; 95% CI, $2.90-$2.91), metropolitan counties ($1.93; 95% CI, $1.93-$1.93), and for individuals aged 35 to 44 years ($2.10; 95% CI, $2.09-$2.10).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cross-sectional study found that mean daily out-of-pocket costs for buprenorphine were lower in 2020 than in 2015, but variation by payer existed in all study years. Financial barriers to accessing and maintaining buprenorphine for opioid use disorder treatment may exist and differ by type of prescription coverage. Future research could monitor costs and identify potential barriers that may impact access and retention in care.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.54590","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T17:48:27Z","timestamp":1676051307000},"page":"e2254590","source":"Crossref","is-referenced-by-count":16,"title":["Trends in Out-of-Pocket Costs for and Characteristics of Pharmacy-Dispensed Buprenorphine Medications for Opioid Use Disorder Treatment by Type of Payer, 2015 to 2020"],"prefix":"10.1001","volume":"6","author":[{"given":"Andrea E.","family":"Strahan","sequence":"first","affiliation":[{"name":"Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaina","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Gery P.","family":"Guy","sequence":"additional","affiliation":[{"name":"Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2023,2,10]]},"reference":[{"issue":"12","key":"zoi221545r4","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1001\/archgenpsychiatry.2011.121","article-title":"Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: a 2-phase randomized controlled trial.","volume":"68","author":"Weiss","year":"2011","journal-title":"Arch Gen Psychiatry"},{"issue":"12","key":"zoi221545r5","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1001\/jamainternmed.2014.5302","article-title":"Primary care-based buprenorphine taper vs maintenance therapy for prescription opioid dependence: a randomized clinical trial.","volume":"174","author":"Fiellin","year":"2014","journal-title":"JAMA Intern Med"},{"issue":"9","key":"zoi221545r6","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1001\/jamapsychiatry.2021.0976","article-title":"Association of opioid agonist treatment with all-cause mortality and specific causes of death among people with opioid dependence: a systematic review and meta-analysis.","volume":"78","author":"Santo","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"zoi221545r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108784","article-title":"Do out-of-pocket costs influence retention and adherence to medications for opioid use disorder?","volume":"225","author":"Dunphy","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"7","key":"zoi221545r10","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1176\/appi.ps.201700315","article-title":"Buprenorphine use and spending for opioid use disorder treatment: trends from 2003 to 2015.","volume":"69","author":"Roberts","year":"2018","journal-title":"Psychiatr Serv"},{"key":"zoi221545r1","volume-title":"Drug overdose deaths in the United States, 1999\u20132020. NCHS Data Brief, no 428","author":"Hedegaard","year":"2021"},{"key":"zoi221545r2","unstructured":"Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: results from the 2020 National Survey on Drug Use and Health. October 2021. Accessed December 20, 2021. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt35325\/NSDUHFFRPDFWHTMLFiles2020\/2020NSDUHFFR1PDFW102121.pdf"},{"key":"zoi221545r3","unstructured":"Substance Abuse and Mental Health Services Administration. Medications for Opioid Use Disorder. July 2021. Accessed January 3, 2023. https:\/\/store.samhsa.gov\/product\/TIP-63-Medications-for-Opioid-Use-Disorder-Full-Document\/PEP21-02-01-002"},{"key":"zoi221545r7","unstructured":"US Department of Health and Human Services. Overdose prevention strategy. Accessed March 17, 2022. https:\/\/www.hhs.gov\/overdose-prevention\/"},{"key":"zoi221545r8","unstructured":"US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. FAQs about the new buprenorphine practice guidelines. Accessed July 22, 2022. https:\/\/www.samhsa.gov\/medication-assisted-treatment\/become-buprenorphine-waivered-practitioner\/new-practice-guidelines-faqs"},{"key":"zoi221545r11","unstructured":"United States Census Bureau. 2010 census regions and divisions of the United States. 2021. Accessed October 20, 2021. https:\/\/www.census.gov\/geographies\/reference-maps\/2010\/geo\/2010-census-regions-and-divisions-of-the-united-states.html"},{"key":"zoi221545r12","unstructured":"Centers for Disease Control and Prevention, National Center for Health Statistics. NCHS urban-rural classification scheme for counties. 2017. 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Accessed January 3, 2023. https:\/\/store.samhsa.gov\/product\/Medicaid-Coverage-of-Medication-Assisted-Treatment-for-Alcohol-and-Opioid-Use-Disorders-and-of-Medication-for-the-Reversal-of-Opioid-Overdose\/SMA18-5093"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2801240\/strahan_2023_oi_221545_1675278163.24398.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T17:48:33Z","timestamp":1676051313000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2801240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,10]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.54590","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,10]]}}}