Between 2017 and 2021, the number of clinicians with 30-patient buprenorphine waivers under the Drug Addiction Treatment Act (DATA) increased in the U.S. Still, nearly 60% of prescriptions for the agent for opioid use disorder (OUD) came from practitioners with 275-patient waivers, a study shows. Since the elimination of the training requirements in June 2021 for treating up to 30 patients with buprenorphine, the number of waivered clinicians increased by 16% but without an increase in buprenorphine use. “With the removal of the waiver entirely in the 2023 Consolidated Appropriations Act, this study brings into question the assumption that eliminating the DATA waiver will lead to substantial increases in buprenorphine access,” the investigators conclude. “While removal of this barrier may make it easier for clinicians to begin prescribing, additional investments may be needed to build and support clinicians treating OUD.”
A list of clinicians waivered by the U.S. Drug Enforcement Administration was matched with clinician-level monthly IQVIA Xponent prescription data for Jan. 2017 to May 2021. Monthly counts of buprenorphine prescriptions by DATA-waivered clinicians were compared with the counts of prescribers with 1 or more prescriptions in a given month using chi-square tests.
“Between January 2017 and May 2021, waivered clinicians increased from 34,149 to 96,415, and clinicians actively prescribing buprenorphine increased from 15,232 to 31,391 but represented a declining proportion of DATA-waivered clinicians (44.6% to 32.6%; P < .001),” the authors write. “In May 2021, there were 68,144 clinicians with a 30-patient limit (monthly prescription volume, 153,800); 20,901 with a 100-patient limit (prescription volume, 367,522); and 7,362 with 275-patient limit (prescription volume, 757,633). In May 2021, clinicians with a 30-patient limit were less likely to actively prescribe compared with clinicians with 100- and 275-patient limits (22.30% vs 49.23% and 80.13%, P < .001), represented the largest share of active prescribers (51.46% vs 31.50% and 17.04%), and prescribed the lowest percentage of monthly total prescription volume (12.02% vs 29.02% and 58.96%).”