Walker Jessica J, Olsen Martin E
From the Quillen College of Medicine, East Tennessee State University, Johnson City.
South Med J. 2018 Oct;111(10):575-578. doi: 10.14423/SMJ.0000000000000875.
This study was undertaken to confirm that patient reports on buprenorphine medicationassisted therapy in for-profit buprenorphine clinics in our community were personally costly. We contacted all 17 for-profit clinics in our community and confirmed the patient reports that a significant financial payment of ≤$100 was required for each visit. We also found that tapering of buprenorphine dosage in pregnancy was offered by several of the clinics.
A telephone survey was conducted with the 17 for-profit buprenorphine clinics located in the Johnson City, Tennessee area. The clinic representative who answered the telephone was asked questions regarding patient costs for therapy and availability of tapering programs for pregnant women.
Patient reports that the for-profit clinics are costly were confirmed. None of the clinics accepted insurance reimbursement of any type. The most common weekly costs were $100 per visit. A majority of clinics offered biweekly or monthly visits at significantly increased rates. Clinic representatives stated that a majority of clinics would consider buprenorphine tapering programs for pregnant women.
The high cost of for-profit clinics is a barrier for patient access to medication-assisted therapy with buprenorphine. Tapering of buprenorphine dosage in pregnant women has penetrated buprenorphine management practice in our community. Further research is needed to determine whether elimination of cost barrier would have a positive effect on the rates of neonatal abstinence syndrome.
本研究旨在证实患者报告称，在我们社区的营利性丁丙诺啡诊所接受丁丙诺啡药物辅助治疗费用高昂。我们联系了社区内所有17家营利性诊所，证实了患者的报告，即每次就诊都需要支付高达100美元的高额费用。我们还发现，几家诊所提供孕期丁丙诺啡剂量递减服务。
对位于田纳西州约翰逊市地区的17家营利性丁丙诺啡诊所进行了电话调查。接听电话的诊所代表被问及治疗的患者费用以及为孕妇提供剂量递减项目的情况。
证实了患者关于营利性诊所费用高昂的报告。没有一家诊所接受任何形式的保险报销。最常见的每周费用是每次就诊100美元。大多数诊所提供每两周或每月就诊服务，费用大幅增加。诊所代表表示，大多数诊所会考虑为孕妇提供丁丙诺啡剂量递减项目。
营利性诊所的高昂费用是患者获得丁丙诺啡药物辅助治疗的障碍。孕妇丁丙诺啡剂量递减已融入我们社区的丁丙诺啡管理实践。需要进一步研究以确定消除费用障碍是否会对新生儿戒断综合征的发生率产生积极影响。
