METHODS: We conducted a retrospective analysis of BUP-N prescriptions filled by NYC residents over a three-year period (2011–2013) using New York State’s PMP data. To examine retention in care, we created an inception cohort of all patients newly prescribed BUP-N in 2011 (without a prior-year BUP-N prescription). Patients were described by gender, age, most frequent payment method, and proportion with <3, 3-6, 7-12, and >12 months of consecutive BUP-N prescriptions filled. We also examined median dose at initiation, and in subsequent buprenorphine prescriptions.
RESULTS: There were 6,119 patients who were newly prescribed buprenorphine-naloxone in 2011. From 2011-2013, this cohort filled 64,458 prescriptions. Patients were 74% male and median age 39 years. The most frequent payment method was commercial insurance (50%), followed by public insurance (31%). The median months filled during the three-year period was 3 (range 1-36). Nearly half (49%) of patients filled <3 months; 22% filled 3-6 months; 14% filled 7-12 months; and 16% filled >12 months. Median dose at initiation was 16 milligrams. For patients with 2 or more months of buprenorphine prescriptions, the median dose was also 16 milligrams.
CONCLUSIONS: NYC residents who newly fill buprenorphine-naloxone prescriptions have short durations of consecutive prescriptions, with nearly half for fewer than 3 months. Future research is needed to elucidate why treatment duration is so short. Extending length of time in treatment may help patients avoid adverse health consequences from opioid use disorders.