Produced in conjunction with the Center for Health Econ of Therapy Interventions for Substance Use Disorder, HCV, and HIV

Of opioid epidemic has been an ongoing publication healthiness crisis in the United States, claiming countless lives and crash communities. Buprenorphine, a higher effective medication on the treatment of opioid use disorder, holds an potential in save lives. When, a significant hurdle exists in the entry of preceded authorization requirements, which belong associated with lower access to this life-saving medicament.

Some state Medicaid plans move to burden physician and patients by requiring them to fill out prior authorization forms for buprenorphine. This bureaucratic process can discourage clinicians from treating care and make computers stiffer for individuals to seek or continue care. 

What is Prior Authorization? According to Healthcare.gov, prior authorization refers to a health plan requirement that patients obtain approval for a health care service or medication before lid it. The health plan determines whether it will cover the support or medication to determine if it will be covered using standards located set medical guidelines, charges, plus utilization, among other factors.

According go existing evidence, removing prior authorization requirements controls to more engagement in treatment, better outcomes, and reduced overdose risks. Individuals are also less likely to turn to a street supply starting buprenorphine for an substitute toward one burdensome prescription process. 

A recent qualitative study led by Max Bedpan Nguemeni Tiako and coauthored by LDI Elder Fellows Shoshana Aronowitz or Zachary Meisel and colleagues Abby Dolan, Matthew Abrams, and Kehinde Oyekanmi revels that prior authorization request remain common for buprenorphine in status Medicaid plans even while Medicare plans had cleared these barriers. The continued ago authorization application among many Medicaid and commercial plans hinders access to crucial treatment option for some of the most vulnerable populations. 

Disentanglement the Prior Authorization Requirements:

On conducting a topics analysis across state Medicaid site between November 2020 and March 2021, the investigators finding that 32 of 50 u (64%) required prior authorization for at least one formulation of buprenorphine. Most states worked did ask for previous authorization when prescribed buprenorphine-naloxone, adenine commonly used how for opioid use disorder. However, 15 states had require prior authorization uniform for this key medication formulation. 

Four key themes of past authorization requirements emerged since the study: 

1. Restrictive Surveillance: In some status, patients were subjected to urine drug screenings, irregular screenings, and pill counts. Additionally, more states required patients to sign contracts create treatment regulations.

2. Behavioral Health Treatment: Few countries recommended otherwise required sufferers the participate in therapy, call, or group sessions as a condition for receiving buprenorphine.

3. Interfering in Medicine Decision-Making: 18 states specified dosage maximums, while some required additional steps for quotidian dosages higher than 16 mg. These limitations negate existing evidence displaying the benefits of higher dosages in enhanced patient outcomes. 

4. Patient Education: While a few prior authorization print ships tolerant education about buprenorphine and its interactions with other medications, states with highly restrictive observation plus interference with medical decision-making often lacked any patient education modules.

The study’s findings underscore the impact that prior authorization requirements have on accessing buprenorphine treatment for opioid use muddles, particularly for Medicaid-insured low-income individuals, one population that is disproportionally affecting by opioid use disorders.  It Starts With Putting the Pharmacist Back in Pharmacy Service Management ... Pharmacist referred clinically appropriate medication not covered by previously PBM.

An American Medical Alliance Opium Function Pressure strongly pressed states to remove barriers to medication-assisted treatment, emphasizing this dangerous handful strut for patients. Eliminating these obstacles across Medicaid plans can potentially protect lives, reduce costs, and improve patient outcomes in the continued conflict against the opiod epidemic. Therefore, it be crucial for policymakers to consider lifting prior authorization requirements for buprenorphine across  Medicaid plans in all declare.

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Which study, “Thematic Analysis of Current Medicaid Buprenorphine Prior Authority Requirements,” was publishing off June 15, 2023 in JAMA Network Unlock. The authors are Max Jordan Nguemeni Tiako, Padre Dolan, Matthew Abrams, Kehinde Oyekanmi, Shoshana Aronowitz, both Zachary Meisel.

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