Department of Population Health Sciences, Weill Cornell Medicine, 425 E 61st St, New York, NY 10065. Email:
Am J Manag Care. 2023 Aug 1;29(8):e257-e260. doi: 10.37765/ajmc.2023.89413.
To investigate trends in Medicare coverage of buprenorphine-naloxone film before and after the FDA approval of its first generic versions.
This study used data from the Part D Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files from 2015 to 2022, which provide information on all stand-alone Medicare/Medicare Advantage Prescription Drug Plans.
We examined the percentage of plans that provided coverage of brand-name and generic buprenorphine-naloxone films with strength 8 mg/2 mg during 2015-2022. Median out-of-pocket (OOP) cost for a 30-day supply was estimated among all plans that provided coverage.
Generic buprenorphine-naloxone film was covered by 82% of Medicare Part D plans in 2020, 2 years after market entry. Coverage of brand-name Suboxone film decreased from 76% in 2019 to 42% in 2020. The median OOP cost of buprenorphine-naloxone films faced by Medicare enrollees decreased from $99 in 2019 to $42 in 2020, driven by the lower price of generic films. In contrast, the OOP cost for brand-name buprenorphine-naloxone film increased gradually from $85 in 2015 to $100 in 2022.
Medicare Part D plan formularies replaced brand-name buprenorphine-naloxone films with the newly approved generic versions. This was accompanied by a substantial decrease in estimated OOP cost faced by Part D enrollees. These changes could potentially increase access to buprenorphine among Medicare enrollees with opioid use disorder.
研究 FDA 批准首个通用版丁丙诺啡-纳洛酮膜片前后，医疗保险对丁丙诺啡-纳洛酮膜片覆盖范围的变化趋势。
本研究使用了 2015 年至 2022 年期间来自处方药物计划配方、药房网络和定价信息文件的 Part D 数据，这些数据提供了所有独立的医疗保险/医疗保险优势处方药计划的信息。
我们研究了 2015-2022 年期间，有多少计划提供了 8mg/2mg 剂量的品牌名和通用丁丙诺啡-纳洛酮膜片的覆盖范围。我们还估算了所有提供覆盖范围的计划中，30 天供应量的自付额中位数。
在市场进入后 2 年的 2020 年，有 82%的医疗保险 Part D 计划涵盖了通用丁丙诺啡-纳洛酮膜片。2019 年的品牌名 Suboxone 膜片覆盖范围从 76%下降到 2020 年的 42%。由于通用膜片价格较低，医疗保险参保者面临的丁丙诺啡-纳洛酮膜片的自付额中位数从 2019 年的 99 美元下降到 2020 年的 42 美元。相比之下，品牌名丁丙诺啡-纳洛酮膜片的自付额从 2015 年的 85 美元逐渐增加到 2022 年的 100 美元。
医疗保险 Part D 计划配方用新批准的通用版本替代了品牌名丁丙诺啡-纳洛酮膜片。这伴随着参保者估计自付额的大幅下降。这些变化可能会增加医疗保险参保者中患有阿片类药物使用障碍者获得丁丙诺啡的机会。
