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• W3209026833 abstract "Opioid use disorder (OUD), a chronic brain disease, can be successfullmanaged with medications (MOUD), including buprenorphine (BPN), methadone and naltrexone. This study characterizes, in OUD patients, the relationship between healthcare costs and utilization as related to BPN persistence and patients not treated with MOUD. This retrospective claims study was conducted with a database of 15.9 million patients during a 45 month period from a national US health plan providing medical/ pharmacy commercial and Medicare Advantage coverage. OUD patients included those with an ICD-9/10 code for OUD in primary or secondary position or a pharmacy claim for any MOUD. Individuals were ≥18 years old and continuous enrollment with medical/pharmacy benefits for 6 months before the index date (first date with evidence of OUD) with ≥6 months of follow-up was required. Three cohorts were evaluated: BPN persistent, BPN non-persistent and untreated (no MOUD claims). Persistence was measured as the number of days from first to last BPN claim before a ≥30-day gap. All-cause and OUD-related emergency department (ED) and inpatient (IP) visits were identified. Intravenous drug use (IVDU) complications were assessed as ED/ IP visits for cellulitis/abscess. Results are reported in aggregate and healthcare utilization (HCU) costs in per patient per year. A total of 31,746 patients with OUD were identified. For the majority (24,995 [79%]) no claims for MOUD during the study period were identified (untreated cohort). Total of 6,751 (21%) patients with OUD had a baseline MOUD claim, of those, 6,063 utilized MOUD within the follow-up. Of those, 2,087 (34%) had claims for BPN with 905 (43%) persistent and 1,182 (57%) non-persistent with 65% discontinuation within 60 days. Total OUD-related costs were highest for the non-persistent as compared to persistent and untreated cohorts ($19,203 vs $9,053 and $16,474). HCU costs were lowest for the persistent cohort across all evaluated ED domains (IVDU complication, OUD-related, all-cause) as compared to non-persistent and untreated ($0 vs $22 and $26; $218 vs $527 and $1,665; $1,033 vs $2,111 and $3,216, respectively). In the follow-up, 34 (4%) of the persistent had an OUD-related ED visit, compared to 125 (11%) of non-persistent (p<0.05) and 6,587 (26%) in untreated. HCU costs were lowest for the persistent across all IP domains (IVDU complication, OUD-related, all-cause) compared to non-persistent and untreated ($92 vs $399 and $1,167; $1,257 vs $7,194 and $9,389; $2,211 vs $12,875 and $15,353, respectively). In the follow-up, 54 (6%) of the persistent had an OUD-related IP visit, as compared to 281 (24%) in the non-persistent (p<0.05) and 5,296 (21%) in untreated. This study highlights the potential economic and clinical benefits of BPN persistence in patients with OUD. The persistent were less likely to utilize the ED or be admitted for all-cause and opioid-related complications and had half the total costs of the non-persistent. Overall, BPN persistence was shown to be low and early discontinuation was common. Barriers to persistent treatment need to be mitigated to allow for early intervention opportunities." @default.
• W3209026833 created "2021-11-08" @default.
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• W3209026833 date "2021-10-01" @default.
• W3209026833 modified "2023-09-27" @default.
• W3209026833 title "236 Buprenorphine Treatment Persistence and Healthcare Expenditures: A Retrospective Claims Study" @default.
• W3209026833 doi "https://doi.org/10.1016/j.annemergmed.2021.09.248" @default.
• W3209026833 hasPublicationYear "2021" @default.
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