More than one in three patients abandoned their first buprenorphine prescription for opioid use disorder in 2024, up from 19% in 2020, according to a study published Aug. 4 in JAMA Network Open. Researchers found that 25.8% of first buprenorphine prescriptions were abandoned overall, highlighting persistent barriers to treatment initiation.
Researchers conducted a retrospective cohort study using deidentified electronic health record data linked with administrative claims from the Optum Labs Data Warehouse. The analysis included 1,428 adults who received a first buprenorphine prescription for opioid use disorder between Jan. 1, 2020, and Sept. 25, 2024. Prescription abandonment was defined as failure to dispense or fill the first prescription within 30 days.
Here are six things to know:
1. Prescription abandonment increased sharply. The share of first buprenorphine prescriptions that were abandoned rose from 19% in 2020 to 37% in 2024 (P = .02).
2. One-quarter of patients abandoned treatment. Among 1,428 patients, 369 (25.8%) did not obtain their first buprenorphine prescription within 30 days, while 1,059 (74.2%) did.
3. Commercial insurance was associated with higher abandonment. Patients who abandoned prescriptions were more likely to have commercial insurance than Medicare Advantage coverage (51.8% vs. 29.4%).
4. Higher deductibles were linked to abandonment. Patients who abandoned prescriptions had higher mean pharmacy deductibles than those who filled them ($483.80 vs. $296.40).
5. Hispanic patients had higher abandonment rates. Hispanic patients represented 10.6% of the abandonment group compared with 4.8% of patients who filled their prescriptions.
6. Patients with prior opioid use disorder, substance use disorder or mental health diagnoses were more likely to fill prescriptions. Individuals who obtained buprenorphine were more likely to have opioid use disorder or overdose, another substance use disorder diagnosis or a mental health diagnosis in the preceding 180 days.
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