(276) Healthcare resource utilization among patients with opioid use disorder insured by Medicaid and treated with monthly injectable buprenorphine: a retrospective claims analysis

Background: : Buprenorphine is an effective medication for opioid use disorder (OUD), available in various formulations. Few studies have examined the healthcare resource utilization impact associated with monthly injectable buprenorphine adherence.

Objective: : The purpose of this analysis was to examine healthcare resource utilization (HCRU) among patients with varying levels of adherence to medications for opioid use disorder (MOUD).

Methods: : A retrospective claims analysis was conducted using the Merative™ MarketScan® Medicaid Multi-State Database. The index selection period was from March 1, 2019–December 31, 2022 and the study period from March 1, 2018–December 31, 2023. The index date was the first claim for extended-release buprenorphine injection (BUP-XR; i.e., SUBLOCADE®) during the index selection period. Patients were required to have continuous enrollment with medical, pharmacy, and behavioral health benefits 12 months prior to index (baseline period) and 12 months after and including index (follow-up period). Patient profiles including demographics, clinical characteristics, and medication use were assessed at baseline. HCRU was assessed during the 12-month follow-up period. Patients were categorized into sub-cohorts by patient’s proportion of days covered (PDC) to BUP-XR during the first 6 months of the follow-up period.

Results: : The 2,741 BUP-XR patients identified were on average 35.9±8.1 years old, 51.3% female, and 71.4% resided in urban areas. Common baseline comorbidities were substance use disorder other than opioids or alcohol (84.0%), depression/bipolar disorder (64.1%), generalized anxiety disorder (62.1%), chronic pain (39.7%), and alcohol use disorder (23.7%). Patients with low adherence to BUP-XR (PDC < 0.2) had an average PDC of 0.5 to all other forms of MOUD during the first 6 months of the follow-up period. Among BUP-XR patients with high adherence (PDC≥0.8) compared to patients with low adherence (PDC < 0.2), Lower rates of all-cause (48.3% vs. 65.9%) and opioid-related (3.8% vs. 12.9%) emergency department use (excluding for detoxification), all-cause (7.7% vs. 18.2%) and opioid-related (0.1% vs. 0.5%) inpatient admissions (excluding for detoxification), and evidence of recurrence of OUD symptoms (i.e., return to use) (7.6% vs. 27.6%) were observed.

Conclusions: : A benefit is seen among patients with high adherence to BUP-XR, including fewer all-cause and opioid related emergency department visits, inpatient admissions, and evidence of recurrence of OUD symptoms compared to patients with low adherence to BUP-XR.

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