Improving Adherence to Medications for Opioid Use Disorder to Prevent Overdose Events

Session Description: Medications for Opioid Use Disorder (MOUD) are an evidence-based strategy to prevent opioid overdoses and related harm. The Centers for Medicare and Medicaid Services recognizes the quality measure that recommends patients receive at least 180 days of pharmacotherapy for OUD without a gap of more than 7 days. Despite these recommendations, approximately 40% of patients discontinue treatment within weeks or months of initiation, and less than 50% will receive at least six-months of pharmacotherapy.
The most prescribed MOUD for outpatient treatment of OUD is buprenorphine. For buprenorphine products to be effective, they need to be taken by patients. This is not always a simple process. Patients need to see their provider, get a prescription, find a pharmacy willing and able to fill it, and be able to pay for it. The continuous treatment process can be derailed at any of these points. Barriers can be further exacerbated by insurance issues, the financial toxicity of treatment, and patient-related factors.
When there is an interruption in care, the risks of overdose increase by 189%, placing patients in harm’s way. Maximizing continuous adherence to the medication is critical. We have published and presented these various barriers to continuous adherence. For this proposal, we focus on factors that affect adherence to buprenorphine products for OUD, using real-world data from multiple public and private payers. We will discuss how these factors interact, the current status quo for patients, and how policy can be implemented to alleviate these factors while leading to non-adherence and overdose.