Conference Coverage

Costs, Treatment Patterns in Patients Using Monthly Injectable Buprenorphine

Edited by:
Anthony Calabro, MA

Key Highlights:

  • Analysis included 663 commercially insured patients initiating extended-release buprenorphine (BUP-XR).
  • Most patients (94.1%) used another medication for opioid use disorder during the 12-month baseline period.
  • Only 24.6% achieved high BUP-XR adherence, but overall health care costs decreased after initiation.
  • Post-initiation all-cause costs dropped from $41,088 to $29,811 annually.

A retrospective claims study presented at the 2025 American Society of Health-System Pharmacists Midyear Clinical Meeting in Las Vegas, NV, evaluated how patient profiles and treatment histories relate to adherence and health care costs following initiation of extended-release buprenorphine (BUP-XR).

For their study, research scientist Courtney E. Flynn, MPH, and colleagues examined data from the Merative MarketScan Commercial and Medicare Database. Specifically, the researchers analyzed commercially insured and Medicare supplemental beneficiaries with opioid use disorder (OUD) who initiated BUP-XR between March 2019 and December 2022. The study participants were required to have 12 months of continuous medical, pharmacy, and behavioral health coverage before and after the index date, defined as the first BUP-XR claim. Baseline assessments included demographics, comorbidities, and medication use, including transmucosal/sublingual buprenorphine and extended-release naltrexone.

The team compared health care resource utilization and all-cause costs between the baseline and follow-up periods, excluding medication for opioid use disorder (MOUD)-related pharmacy costs.

Study Findings

The analysis included 663 patients who, on average, were 37.5 years old, predominantly men (67.4%), and resided in the South (45.1%). Psychiatric and substance use comorbidities were common, including alcohol use disorder (22.2%), other substance use disorder (52.8%), depression or bipolar disorder (47.1%), anxiety (52.2%), and chronic pain (39.5%).

MOUD use was widespread before BUP-XR initiation: 94.1% of patients received another MOUD in the baseline period, with transmucosal/sublingual buprenorphine used by 94.0%. Among these patients, the earliest MOUD claim occurred an average of 265.5 days pre-index, and the latest occurred approximately 26.0 days before starting BUP-XR. One month prior to BUP-XR, 79.0% were actively using buprenorphine.

During follow-up, patients remained on BUP-XR for an average of 137.6 days. A small subset (20.5%) received a concurrent prescription for buprenorphine during the first week after initiation. High adherence, defined as a proportion of days covered ≥0.8, was achieved in 24.6% of the cohort. Importantly, average all-cause costs decreased from $41,088 in the baseline period to $29,811 after BUP-XR initiation.

Clinical Implications

According to the study authors, the findings suggest that initiating BUP-XR may lower overall healthcare costs for commercially insured patients with OUD. They noted that despite relatively low adherence rates, reductions in health care resource utilization contributed to decreased all-cause spending in the year following BUP-XR initiation.

Expert Commentary

“A cost benefit is seen amongst patients initiating BUP-XR,” Flynn and colleagues concluded. “On average, patients appear to have lower all-cause health care resource utilization cost after BUP-XR initiation. Further investigation is needed to explore how baseline MOUD treatment patterns have an impact on adherence to BUP-XR and MOUD overall, and health outcomes post-initiation of BUP-XR.”

Reference

Flynn CE, Jerry M, Tran AT, Thompson M, Mullen W. Patient profiles, treatment patterns, and cost among commercially insured opioid use disorder patients treated with monthly injectable buprenorphine: a retrospective claims analysis. Paper presented at: ASHP Midyear Clinical Meeting; December 7-10, 2025; Las Vegas, NV. Accessed December 05, 2025. https://midyear2025.eventscribe.net/fsPopup.asp?efp=V0lBRFdHT1YyNTEwOQ&PosterID=757244&rnd=0.7161261&mode=posterInfo.