The Risk of Misuse and Diversion of Buprenorphine for Opioid Use Disorder in Medicare Part D Continues to Appear Low: 2022

WHY OIG DID THIS REVIEW

• Ensuring access to buprenorphine to treat individuals with opioid use disorder is a critical step in addressing the Nation's opioid crisis.
• Buprenorphine—the most common medication used to treat opioid use disorder—has been shown to decrease illicit opioid use and opioid-related overdose deaths. Yet, due to concerns that buprenorphine has the potential for misuse and is at risk for diversion, access to this medication has historically been restricted.
• The Office of Inspector General recently conducted an evaluation examining the use of buprenorphine in Medicare Part D in 2021 and found that buprenorphine's risk of misuse and diversion appeared to be low.
• This data brief provides updated information—based on prescription drug event data from 2022—on the use of buprenorphine in Medicare Part D and its risk for diversion.

WHAT OIG FOUND

• As in 2021, almost all Medicare Part D enrollees who received buprenorphine for the treatment of opioid use disorder received the recommended amounts in 2022.
• Most enrollees received buprenorphine-naloxone combination products which are generally recommended to minimize the risk of misuse or diversion.
• Enrollees rarely received either very high amounts of buprenorphine or received buprenorphine at the same time as they received high amounts of other opioids.

WHAT OIG CONCLUDES

• The findings from 2022 are similar to the findings from 2021. Together, they suggest that the risk of misuse and diversion of buprenorphine in Medicare Part D continues to be low.
• These updated data provide important information about buprenorphine utilization that can assist the Centers for Medicare & Medicaid Services, the U.S. Department of Health and Human Services, and others as they continue to take steps to improve access to buprenorphine, while also ensuring that the risk of misuse and diversion remains low.