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Buprenorphine Initiation and Retention in the U.S.

Only 1 in 5 patients initiating monthly buprenorphine therapy in Jan. 2016 through Oct. 2022 continued treatment for opioid use disorder for at least 180 days, a study shows. While the monthly buprenorphine initiation rate increased during the early part of this time period, it flattened before the COVID-19 pandemic, the authors note, suggesting that “factors other than the pandemic were involved.”

The IQVIA Longitudinal Prescription Database was used to identify prescriptions for immediate-release and extended-release buprenorphine products approved for opioid use disorder that were dispensed during the study period to patients in 1 the U.S. The monthly buprenorphine initiation rate (number of U.S. patients initiating buprenorphine therapy per 100,000 individuals) and the monthly proportion retained in therapy showed these patterns for 94 million prescriptions dispensed to 3 million patients (43% female): “During January 2016 through September 2018, the monthly buprenorphine initiation rate increased from 12.5 to 15.9 per 100,000 (monthly percentage change, 0.62% [95% CI, 0.40% to 0.84%]; P < .001). During October 2018 through October 2022, the slope was flat (monthly percentage change, −0.03% [95% CI, −0.16% to 0.09%]; P = .62). The median monthly buprenorphine initiation rate during March 2020 through December 2020 (14.4 per 100,000) was slightly lower than during January 2019 through February 2020 (15.5 per 100,000) and January 2021 through October 2022 (15.0 per 100,000).…

“During January 2016 through April 2022, the median monthly retention rate was 22.2% (IQR, 21.5%-23.0%). The retention rate increased minimally without any slope changes (monthly percentage change, 0.08% [95% CI, 0.005% to 0.15%]; P = .04).…”

Source: JAMA