Understanding What Is the Prescription Rate for Buprenorphine

In 2023, the national dispensing rate for buprenorphine was 4.7 prescriptions per 100 persons, though this rate remained relatively stable from 2019 to 2023. Understanding what is the prescription rate for buprenorphine requires exploring significant regional disparities and the impact of recent policy changes.

Quick Summary

This article examines recent prescription data for buprenorphine, exploring national trends, significant state-level disparities, and the factors influencing prescribing patterns. It details the effects of eliminating the federal X-waiver and highlights persistent barriers that still hinder access to this critical medication for opioid use disorder.

Key Points

• National Rate Steady: In 2023, the national dispensing rate for buprenorphine was 4.7 prescriptions per 100 persons, stable since 2019.

• Significant State Variation: Rates differ dramatically by state, influenced by factors like overdose rates, healthcare, and state policies.

• X-Waiver Eliminated: The federal X-waiver was removed in 2023, allowing more providers to prescribe without patient limits.

• Persistent Barriers Remain: Stigma, resource gaps, insurance issues, and retention challenges continue to hinder access.

• Treatment Gap Persists: Access has not kept pace with the need for OUD treatment.

• Telehealth and NPs/PAs Drive Growth: Expanded access via telehealth and non-physician providers has increased prescriptions, especially in rural areas.

• Community Context Matters: Local factors like overdose rates and Medicaid enrollment correlate with prescribing rates.

Buprenorphine Prescription Rate: National Trends and Figures

The national buprenorphine dispensing rate was 4.7 prescriptions per 100 people in 2023, consistent with rates from 2019 to 2023. While prescribing increased between 2010 and 2018, particularly after allowing nurse practitioners and physician assistants to prescribe, the rate of new buprenorphine treatment initiations leveled off by late 2022, indicating a gap between need and access.

The Impact of the X-Waiver Elimination

A significant policy change in 2023 was the elimination of the federal DATA waiver, or X-waiver. This change allows any provider with a standard DEA registration (with Schedule III authority) to prescribe buprenorphine for OUD, removing patient limits. The ability to prescribe via telehealth was also reinforced. However, initial data does not show a dramatic increase in prescribing, suggesting other barriers persist.

State-by-State Disparities in Buprenorphine Prescribing

Buprenorphine prescription rates vary significantly by state, reflecting differences in local factors and access. In 2023, states like West Virginia had rates as high as 25.9 per 100 persons, while others like Texas had rates as low as 1.4. These differences are linked to factors such as overdose rates, healthcare infrastructure, and state policies. States with more accessible treatment systems and expanded Medicaid often show higher rates. For a comprehensive list of state-by-state dispensing rates, refer to resources from the {Link: CDC https://www.cdc.gov/overdose-prevention/data-research/facts-stats/buprenorphine-dispensing-maps.html} and {Link: Statista https://www.statista.com/statistics/1440199/buprenorphine-dispensing-rates-by-state/}.

Ongoing Barriers to Buprenorphine Treatment

Despite the X-waiver removal, challenges remain. These include stigma towards OUD, lack of integrated behavioral health support, insurance issues like prior authorization requirements, low reimbursement rates, and difficulties retaining patients in treatment. Supply chain issues and concerns about DEA enforcement among pharmacies also pose challenges.

Expanding Access and Improving Retention

Strategies to increase access include new care models and expanded provider roles. Hub-and-spoke models help centralize complex care and distribute workload. Telehealth remains vital for reaching underserved areas, and integrating treatment into community programs can help connect with more patients. Increased training for primary care providers is also essential.

The Future of Buprenorphine Prescribing

While policy changes have aimed to remove regulatory hurdles, national dispensing rates have been stable. Future increases depend on addressing ongoing barriers like stigma, resource limitations, and insurance issues at local levels. Innovative care models, public health strategies, and focusing on health equity are crucial to meeting the need for buprenorphine treatment.

Frequently Asked Questions

What was the national prescription rate for buprenorphine in 2023?

The national buprenorphine dispensing rate in 2023 was 4.7 prescriptions per 100 persons, consistent with rates between 2019 and 2023.

Why do some states have much higher buprenorphine prescription rates than others?

Rates vary by state due to factors like the prevalence of OUD, provider availability, state policies, and treatment models.

How did the elimination of the X-waiver affect buprenorphine prescribing?

The X-waiver removal allows any DEA Schedule III registered provider to prescribe without patient limits. However, initial data shows a limited increase in rates.

What barriers still prevent wider access to buprenorphine treatment?

Barriers include stigma, lack of behavioral health support, insurance issues, and challenges with patient retention.

Have healthcare providers other than physicians played a role in increasing buprenorphine access?

Yes, authorization of nurse practitioners and physician assistants in 2017 increased prescriptions, particularly in rural areas.

Is the number of buprenorphine prescriptions meeting the need for opioid use disorder treatment?

No, despite increases, a significant gap remains between those needing and accessing OUD treatment.

How do telehealth services impact buprenorphine prescribing?

Telehealth expands access, especially in underserved areas, by reducing geographical barriers.