Small Number of Clinicians Account for Half of All Buprenorphine Prescriptions

Half of all prescriptions for buprenorphine to treat opioid use disorder in 2017 and 2018 were written by just 4.9% of the physicians and other providers who were waivered to provide the drug, according to research published this week by RAND Corp.

Findings of the study were published by the Journal of the American Medical Association.

RAND researchers used IQVIA Prescription data, which accounts for 90% of all prescriptions filled at retail pharmacies in the U.S. to identify clinicians who prescribed buprenorphine between January 2017 and December 2018. The researchers then calculated the total months of patient care each clinician provided.

Clinicians identified as high-volume prescribers treated an average of 124 patients per month, although most such providers were waivered for up to 275 patients at one time. Primary care physicians (63.6%), psychiatrists (14.3%), pain specialists (8.3%) accounted for more than 85% of buprenorphine prescriptions written. Addiction specialists accounted for just 4.4%.

“Given that a relatively low number of providers account for most of the buprenorphine prescribing, providing targeted support to those willing to safely treat more patients may be a more promising strategy to increase medication treatment among people struggling with opioid addiction than primarily focusing on increasing the number of new prescribers,” study lead author Bradley D. Stein, MD, PhD, senior physician researcher at RAND, said in a news release.