Association between Medicare and FDA policies and prior authorization requirements for buprenorphine products in Medicare Part D plans
JAMA Jul 15, 2019
Mark TL, et al. – In this study, researchers determined the correlation between Medicare and FDA policies and prior authorization requirements for buprenorphine products in Medicare Part D plans. In 2016, approximately 1.2% of Medicare beneficiaries were misusing opioid prescriptions, which was twice the prevalence in 2006. Buprenorphine, either alone or with naloxone, was noted to be an efficacious treatment for opioid use disorder, and was included under Medicare Part D. For opioid use disorder, 57% of Medicare Part D plans needed prior authorization to prescribe buprenorphine-naloxone, as of January 2018, and to prescribe buprenorphine, 66% needed prior authorization. However, in order to promote relevant medication use and contain spending health plans used prior authorization, it could also decrease the likelihood that a patient obtains prescribed medications and lead to worse results.
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