• Bradley D Stein, Rachel K Landis, Flora Sheng, Brendan Saloner, Adam J Gordon, Mark Sorbero, and Andrew W Dick.
• RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA. stein@rand.org.
• J Gen Intern Med. 2023 Feb 1; 38 (3): 733737733-737.

BackgroundDuring the COVID pandemic, overall buprenorphine treatment appeared to remain relatively stable, despite some studies suggesting a decrease in patients starting buprenorphine. There is a paucity of empirical information regarding patterns of buprenorphine treatment during the pandemic.ObjectiveTo better understand the patterns of buprenorphine episodes during the pandemic and how those patterns compared to pre-pandemic patterns.DesignPharmacy claims representing approximately 92% of all prescriptions filled at retail pharmacies in all 50 US states and the District of Columbia.ParticipantsIndividuals filling buprenorphine prescriptions indicated for treatment of opioid use disorder.Main MeasuresThe number of active, starting, and ending buprenorphine treatment episodes March 13 to December 1, 2020, and the expected number of such episodes in 2020 based on the growth in treatment episodes from March 13 to December 1, 2019.Key ResultsThe observed number of active buprenorphine episodes in December 2020 was comparable to the expected number, but new treatment episodes starting between March 13 and December 1, 2020, were 17.2% fewer than expected based on the 2019 experience. Similarly, the number of episodes that ended between March 13 and December 1, 2020, was 16.0% fewer than expected. Decreases from expected episode starts and ends occurred throughout the period but were greatest in the 2 months after the declaration of the public health emergency.Conclusions And RelevanceBeneath the apparent stability of buprenorphine patient numbers during the pandemic, the flow of individuals receiving buprenorphine treatment changed substantially. Our findings shed light on how policy changes meant to support buprenorphine prescribing influenced prescribing dynamics during that period, suggesting that while policy efforts may have been successful in maintaining existing patients in treatment, that success did not extend to individuals not yet in treatment.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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