Despite its efficacy for treatment of opioid use disorder, barriers to buprenorphine prescribing persist, including insurance restrictions.
In the May 2023 issue of Health Affairs, Barbara Andraka-Christou and coauthors investigate formulary files for Medicaid, Medicare Advantage, and commercial insurance plans to assess changes to prior authorization requirements and quantity limits for immediate-release and extended-release buprenorphine from 2017 to 2021 by insurer type.
They find "decreasing prior authorization requirements for buprenorphine in recent years, with only a small percentage of formularies still requiring prior authorization."
Among Medicaid and commercial insurers, quantity limits for immediate-release buprenorphine were relatively rare.
However, "approximately half of Medicare Advantage formularies had quantity limits on immediate-release buprenorphine tablets" with the proportion of
formularies with quantity limits increasing from 2017 to 2021. For a full discussion of their findings and the broader implications, read Andraka-Christou and coauthors full article today.
They write that this status is a "perfect example of how health insurance rules can have unintended and harmful consequences for patients and their families."
Brady Post on the Considerable Relationship
Between Consolidation and Health Care Treatment Intensity
Alan Weil interviews Brady Post from Northeastern University on his recently published paper examining differences in care among patients treated by cardiologists who are either practicing independently or as part of a hospital system.
During May, we're highlighting influential Asian American, Native Hawaiian, and
Pacific Islander voices and organizations who have made an impact on health equity and policy.
In a March 2023 article, Jay Varma and coauthors discuss steps that policy makers can take to strengthen the current system and to prepare the country for the next
pandemic.
Health Affairs is launching a contest! The premise is simple. Finish the statement "You’re A Health Policy Wonk If…"
We'll share some of the submissions on Forefront in July, and the first-place winner of the contest will receive a Health Affairs tumbler and a free Unlimited membership for a year. Submit by May 31.
About Health Affairs
Health Affairs is the leading peer-reviewedjournalat the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking
content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.
Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.
