RAND Corporation, Santa Monica, CA, United States of America.
RAND Corporation, Boston, MA, United States of America.
J Subst Abuse Treat. 2021 Oct;129:108384. doi: 10.1016/j.jsat.2021.108384. Epub 2021 Apr 8.
To quantify weekly rates of use of buprenorphine for those with employer-based insurance and whether the rate differs based on county-level measures of race, historical fatal drug overdose rate, and COVID-19 case rate.
We used 2020 pharmaceutical claims for 4.8 million adults from a privately insured population to examine changes in the use of buprenorphine to treat opioid use disorder in 2020 during the onset of the COVID-19 pandemic. We quantified variation by examining changes in use rates across counties based on their fatal drug overdose rate in 2018, number of COVID-19 cases per capita, and percent nonwhite.
Weekly use of buprenorphine was relatively stable between the first week of January (0.6 per 10,000 enrollees, 95%CI = 0.2 to 1.1) and the last week of August (0.8 per 10,000 enrollees, 95%CI = 0.4 to 1.3). We did not find evidence of any consistent change in use of buprenorphine by county-level terciles for COVID-19 rate as of August 31, 2020, age-adjusted fatal drug overdose rate, and percent nonwhite. Use was consistently higher for counties in the highest tercile of county age-adjusted fatal drug overdose rate when compared to counties in the lowest tercile of county age-adjusted fatal drug overdose rate.
Our results provide early evidence that new federal- and state-level policies may have steadied the rate of using buprenorphine for those with employer-based insurance during the pandemic.
量化有雇主保险的人群中丁丙诺啡每周的使用频率，以及该频率是否因县一级的种族、历史致命药物过量率和 COVID-19 病例率等指标而有所不同。
我们使用了来自一个私人保险人群的 480 万成年人的 2020 年药物索赔数据，以研究在 COVID-19 大流行开始时，2020 年丁丙诺啡治疗阿片类药物使用障碍的使用频率变化。我们通过检查根据 2018 年致命药物过量率、每千人 COVID-19 病例数和非白人比例，各县的使用频率变化来量化这种变化。
在 2020 年 1 月第一周（每千名参保者 0.6 人，95%置信区间 0.2 至 1.1）和 8 月最后一周（每千名参保者 0.8 人，95%置信区间 0.4 至 1.3）之间，丁丙诺啡的每周使用量相对稳定。我们没有发现任何证据表明，截至 2020 年 8 月 31 日，按 COVID-19 发病率、县年龄调整致命药物过量率和非白人比例划分的县三级中，丁丙诺啡的使用情况有任何一致的变化。与县年龄调整致命药物过量率最低的三级相比，县年龄调整致命药物过量率最高的三级的县的使用量始终较高。
我们的结果提供了早期证据，表明新的联邦和州一级政策可能在大流行期间稳定了有雇主保险的人群中使用丁丙诺啡的频率。
