Racial and Ethnic Disparities in Buprenorphine and Extended-Release Naltrexone Filled Prescriptions During the COVID-19 Pandemic
Published Year: 06/01/2022
Question Did pandemic disruptions in filled buprenorphine and extended-release naltrexone prescriptions for opioid use disorder (OUD) differ by race and ethnicity or insurance status and payer type?
Findings In this cross-sectional study of 92% of US retail pharmacy claims of buprenorphine among 1 556 860 individuals and extended-release naltrexone among 127 506 individuals for OUD from May 2019 to June 2021, prepandemic growth rate of buprenorphine fills significantly flattened overall after pandemic onset (30.5 percentage points relative trend decrease over 1 year). However, immediate significant level decreases in buprenorphine prescriptions at pandemic onset (2.5% to 4.0%) were concentrated among members of racial and ethnic minority groups but not White patients.
Meaning These findings suggest that the COVID-19 pandemic may have been associated with worsened disparities in filled buprenorphine and naltrexone prescriptions for OUD among members of racial and ethnic minority groups compared with White patients.
Importance COVID-19 disrupted delivery of buprenorphine and naltrexone treatment for opioid use disorder (OUD), and during the pandemic, members of racial and ethnic minority groups experienced increased COVID-19 and opioid overdose risks compared with White individuals. However, whether filled buprenorphine and naltrexone prescriptions varied across racial and ethnic groups during the COVID-19 pandemic remains unknown.
Objective To investigate whether disruptions in filled buprenorphine and naltrexone prescriptions differed by race and ethnicity and insurance status or payer type.
Design, Setting, and Participants This cross-sectional study used retail pharmacy claims from May 2019 to June 2021 from the Symphony Health database, which includes 92% of US retail pharmacy claims, with race and ethnicity data spanning all insurance status and payer categories. Interrupted time series were used to estimate levels and trends of dispensed buprenorphine and naltrexone prescriptions before and after pandemic onset. Included individuals were those who filled buprenorphine and extended-release naltrexone prescriptions. Data were analyzed from July 2021 through March 2022.