{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:24:34Z","timestamp":1791883474281,"version":"4.3.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Buprenorphine is a key medication to treat opioid use disorder (OUD). Since its approval in 2002, buprenorphine access has grown markedly, spurred by major federal and state policy changes. This study characterizes buprenorphine treatment episodes during 2007 to 2018 with respect to payer, provider specialty, and patient demographics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this observational cohort study, IQVIA Real World pharmacy claims data were used to characterize trends in buprenorphine treatment episodes across four time periods: 2007-2009, 2010-2012, 2013-2015, and 2016-2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, we identified more than 4.1\u2009million buprenorphine treatment episodes among 2\u2009540\u2009710 unique individuals. The number of episodes doubled from 652\u2009994 in 2007-2009 to 1\u2009331\u2009980 in 2016-2018. Our findings indicate that the payer landscape changed dramatically, with the most pronounced growth observed for Medicaid (increased from 17% of episodes in 2007-2009 to 37% of episodes in 2016-2018), accompanied by relative declines for both commercial insurance (declined from 35 to 21%) and self-pay (declined from 27 to 11%). Adult primary care providers (PCPs) were the dominant prescribers throughout the study period. The number of episodes among adults older than 55 increased more than 3-fold from 2007-2009 to 2016-2018. In contrast, youth under age 18 experienced an absolute decline in buprenorphine treatment episodes. Buprenorphine episodes increased in length from 2007-2018, particularly among adults over age 45.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our findings demonstrate that the U.S. experienced clear growth in buprenorphine treatment\u2014particularly for older adults and Medicaid beneficiaries\u2014reflecting some key health policy and implementation success stories. Yet, since the prevalence of OUD and fatal overdose rate have also approximately doubled during this period, the observed growth in buprenorphine treatment did not demonstrably impact the pronounced treatment gap. To date, only a minority of individuals with OUD currently receive treatment, indicating continued need for systemic efforts to equitably improve treatment uptake.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08897077231179576","type":"journal-article","created":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T16:28:52Z","timestamp":1686068932000},"page":"154-163","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["National Trends in Buprenorphine Treatment for Opioid Use Disorder From 2007 to 2018"],"prefix":"10.1177","volume":"44","author":[{"given":"Megan S.","family":"Schuler","sequence":"first","affiliation":[{"name":"RAND Corporation, Arlington, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Saloner","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Program for Addiction Research, Clinical Care Knowledge and Advocacy (PARCKA) Department of Internal Medicine, University of Utah School of Medicine, and Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"Dick","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley D.","family":"Stein","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"key":"bibr1-08897077231179576","unstructured":"National Institute on Drug Abuse. Overdose death rates. 2022. Accessed April 1, 2022. https:\/\/nida.nih.gov\/drug-topics\/trends-statistics\/overdose-death-rates"},{"key":"bibr2-08897077231179576","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:122556"},{"key":"bibr3-08897077231179576","unstructured":"Assistant Secretary of Policy Evaluation. Issue Brief: Opioid abuse in the US and HHS actions to address opioid-drug related overses and deaths. 2015. Accessed April 1, 2022. https:\/\/aspe.hhs.gov\/sites\/default\/files\/pdf\/107956\/ib_OpioidInitiative.pdf"},{"key":"bibr4-08897077231179576","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302664"},{"key":"bibr5-08897077231179576","doi-asserted-by":"publisher","DOI":"10.17265\/2159-5313\/2016.09.003"},{"key":"bibr6-08897077231179576","unstructured":"US Department of Health and Human Services. Practice guidelines for the administration of buprenorphine for treating opioid use disorder. April 28, 2021. Accessed January 1, 2022. https:\/\/www.federalregister.gov\/documents\/2021\/04\/28\/2021-08961\/practice-guidelines-for-the-administration-of-buprenorphine-for-treating-opioid-use-disorder"},{"key":"bibr7-08897077231179576","unstructured":"Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. (2018). U.S.C. 823(g)(2)(G)(iii)."},{"key":"bibr8-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.18913"},{"key":"bibr9-08897077231179576","unstructured":"National Institute on Drug Abuse. Buprenorphine misuse decreased among U.S. adults with opioid use disorder from 2015-2019. 2021. Accessed April 1, 2022. https:\/\/bit.ly\/3MrBa83"},{"key":"bibr10-08897077231179576","unstructured":"IQVIA: Real World Data and Insights. 2023. Accessed January 1, 2023. https:\/\/www.iqvia.com\/solutions\/real-world-evidence\/real-world-data-and-insights"},{"key":"bibr11-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.3821"},{"key":"bibr12-08897077231179576","volume-title":"Drug Overdose Deaths in the United States, 1999-2016","author":"Hedegaard H","year":"2017"},{"key":"bibr13-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.11859"},{"key":"bibr14-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2011.10.016"},{"key":"bibr15-08897077231179576","doi-asserted-by":"publisher","DOI":"10.3109\/00952990.2012.741167"},{"key":"bibr16-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1111\/add.14436"},{"key":"bibr17-08897077231179576","doi-asserted-by":"publisher","DOI":"10.7326\/M19-2403"},{"key":"bibr18-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202100122"},{"key":"bibr19-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00859"},{"key":"bibr20-08897077231179576","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108715"},{"key":"bibr21-08897077231179576","unstructured":"Medicaid Enrollment Changes Following the ACA. 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