{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:39:18Z","timestamp":1792917558612,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2025,2,10]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Buprenorphine is an atypical opioid with analgesic efficacy and a more favorable safety profile than conventional opioids or tramadol. In 2019, access to on-label buprenorphine formulations was limited in comparison to conventional opioids, despite evidence supporting buprenorphine\u2019s first-line analgesic use. Considering recent policy changes increasing buprenorphine accessibility, we determined differences in unrestricted insurance coverage between buprenorphine, conventional opioids, and other atypical opioids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from Managed Market Insights and Technology\u2019s Coverage Search and Kaiser Family Foundation to generate estimates on percentages of US-covered lives with unrestricted access to oxycodone, morphine, tramadol, tapentadol, generic and on-label transdermal buprenorphine, on-label buccal buprenorphine, and on-label sublingual buprenorphine\/naloxone in 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>79.7% of commercial and 99.1% of Medicare lives had unrestricted oxycodone access. Morphine access was unrestricted for 45.7% of commercial and 62.8% of Medicare lives. Unrestricted access to tramadol was available for 88.2% of commercial and 96.3% of Medicare lives. 37.3% of commercial and 10.1% of Medicare lives had unrestricted tapentadol access. Unrestricted access to on-label transdermal buprenorphine was available for 21.0% of commercial and 2.59% of Medicare lives. Generic transdermal buprenorphine was available for 52.1% of commercial and 30.0% of Medicare lives. Buccal buprenorphine was available without restriction for 52.7% of commercial and 19.8% of Medicare lives. Sublingual buprenorphine\/naloxone had unrestricted coverage for 34.6% of commercial and 32.7% of Medicare lives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Access to buprenorphine formulations was limited in comparison to other opioids. This study emphasizes a need for commercial and Medicare health insurance plans to broaden buprenorphine coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2024-106306","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T19:00:25Z","timestamp":1740078025000},"page":"670-673","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Unrestricted insurance coverage of buprenorphine formulations remains sparse in comparison to conventional opioids"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5743-7623","authenticated-orcid":false,"given":"Bennett","family":"Andrassy","sequence":"first","affiliation":[{"name":"Pain Labs, New Albany, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junaid","family":"Mukhdomi","sequence":"additional","affiliation":[{"name":"Pain Labs, New Albany, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Bhaskar","sequence":"additional","affiliation":[{"name":"Brown University Warren Alpert Medical School, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Harris","sequence":"additional","affiliation":[{"name":"Pain Labs, New Albany, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taif","family":"Mukhdomi","sequence":"additional","affiliation":[{"name":"Pain Labs, New Albany, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"2026061805150763000_51.6.670.1","doi-asserted-by":"crossref","first-page":"3691","DOI":"10.1093\/pm\/pnaa089","article-title":"Is Buprenorphine Effective for Chronic Pain? A Systematic Review and Meta-analysis","volume":"21","author":"Lazaridou","year":"2020","journal-title":"Pain Med"},{"key":"2026061805150763000_51.6.670.2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006467"},{"key":"2026061805150763000_51.6.670.3","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2217\/pmt-2020-0013","article-title":"Buprenorphine buccal film for chronic pain management","volume":"10","author":"Hale","year":"2020","journal-title":"Pain Manag"},{"key":"2026061805150763000_51.6.670.4","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S305146"},{"key":"2026061805150763000_51.6.670.5","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen094"},{"key":"2026061805150763000_51.6.670.6","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s40122-022-00380-2","article-title":"Pharmacokinetics of Buprenorphine Buccal Film and Orally-administered Oxycodone in a Respiratory Study: An Analysis of Secondary Outcomes from a Randomized Controlled Trial","volume":"11","author":"Webster","year":"2022","journal-title":"Pain Ther"},{"key":"2026061805150763000_51.6.670.7","doi-asserted-by":"crossref","DOI":"10.52965\/001c.37517","article-title":"Buprenorphine and its formulations: a comprehensive review","volume":"10","author":"Poliwoda","year":"2022","journal-title":"Health Psychol Res"},{"key":"2026061805150763000_51.6.670.8","doi-asserted-by":"crossref","DOI":"10.1155\/2017\/2071494","article-title":"Efficacy and Safety of Transdermal Buprenorphine versus Oral Tramadol\/Acetaminophen in Patients with Persistent Postoperative Pain after Spinal Surgery","volume":"2017","author":"Lee","year":"2017","journal-title":"Pain Res Manag"},{"key":"2026061805150763000_51.6.670.9","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1093\/pm\/pnz356","article-title":"Understanding Buprenorphine for Use in Chronic Pain: Expert Opinion","volume":"21","author":"Webster","year":"2020","journal-title":"Pain Med"},{"key":"2026061805150763000_51.6.670.10","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1093\/pm\/pnz197","article-title":"Limited Access to On-Label Formulations of Buprenorphine for Chronic Pain as Compared with Conventional Opioids","volume":"21","author":"Fishman","year":"2020","journal-title":"Pain Med"},{"key":"2026061805150763000_51.6.670.11","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1213\/ANE.0000000000002718","article-title":"Treatment of Chronic Pain With Various Buprenorphine Formulations: A Systematic Review of Clinical Studies","volume":"127","author":"Aiyer","year":"2018","journal-title":"Anesthesia & Analgesia"},{"key":"2026061805150763000_51.6.670.12","unstructured":"SAMHSA . Waiver elimination (MAT act). samhsa.gov; 2023. 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MMIT network. 2024. Available: https:\/\/www.mmitnetwork.com\/coverage-search [Accessed 15 Feb 2024]."},{"key":"2026061805150763000_51.6.670.22","unstructured":"Health insurance coverage of the total population . KFF. 2023. Available: https:\/\/www.kff.org\/other\/state-indicator\/total-population\/?currentTimeframe=0&sortModel=%7B%22colId%22%3A%22Location%22%2C%22sort%22%3A%22asc%22%7D [Accessed 15 Feb 2024]."},{"key":"2026061805150763000_51.6.670.23","unstructured":"American Community Survey Tables for Health Insurance Coverage . United States Census Bureau. 2023. Available: https:\/\/www.census.gov\/data\/tables\/time-series\/demo\/health-insurance\/acs-hi.html [Accessed 15 Feb 2024]."},{"key":"2026061805150763000_51.6.670.24","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1080\/03007995.2020.1832977","article-title":"Safety of tapentadol compared with other opioids in chronic pain treatment: network meta-analysis of randomized controlled and withdrawal trials","volume":"37","author":"Freynhagen","year":"2021","journal-title":"Curr Med Res Opin"},{"key":"2026061805150763000_51.6.670.25","doi-asserted-by":"crossref","DOI":"10.1001\/jamahealthforum.2023.1102","article-title":"Association of Selected State Policies and Requirements for Buprenorphine Treatment With Per Capita Months of Treatment","volume":"4","author":"Stein","year":"2023","journal-title":"JAMA Health Forum"},{"key":"2026061805150763000_51.6.670.26","doi-asserted-by":"crossref","first-page":"103786","DOI":"10.1016\/j.drugpo.2022.103786","article-title":"Has the treatment gap for opioid use disorder narrowed in the U.S.?: A yearly assessment from 2010 to 2019\"","volume":"110","author":"Krawczyk","year":"2022","journal-title":"Int J Drug Policy"},{"key":"2026061805150763000_51.6.670.27","doi-asserted-by":"crossref","DOI":"10.1001\/jamahealthforum.2023.3549","article-title":"Removal of Medicaid Prior Authorization Requirements and Buprenorphine Treatment for Opioid Use Disorder","volume":"4","author":"Christine","year":"2023","journal-title":"JAMA Health Forum"},{"key":"2026061805150763000_51.6.670.28","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1377\/hlthaff.2022.01513","article-title":"Buprenorphine Treatment For Opioid Use Disorder: Comparison Of Insurance Restrictions, 2017-21","volume":"42","author":"Andraka-Christou","year":"2023","journal-title":"Health Aff (Millwood)"},{"key":"2026061805150763000_51.6.670.29","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001189"},{"key":"2026061805150763000_51.6.670.30","doi-asserted-by":"crossref","first-page":"208981","DOI":"10.1016\/j.josat.2023.208981","article-title":"Higher buprenorphine dose associated with increased treatment retention at low threshold buprenorphine clinic: A retrospective cohort study","volume":"147","author":"Selitsky","year":"2023","journal-title":"J Subst Use Addict Treat"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2024-106306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T12:16:09Z","timestamp":1781784969000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2024-106306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,5]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/rapm-2024-106306"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2024-106306","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,20]]}}}