[ad_1]
Buprenorphine, a newcomer in the treatment of opioid addiction, is gaining popularity among California physicians as regulatory changes, physician training and other initiatives make the drug more accessible.
The rate of enrollment within Medi-Cal who received buprenorphine almost quadrupled between the end of 2014 and the third quarter of 2018, according to data published by Medi-Cal, the state's Medicaid program. The methadone rate – an older and more commonly used drug – remained virtually unchanged from the end of 2014 to the last quarter of 2017, the most recent period for which data are available.
Buprenorphine and methadone are opioids. Both reduce heroin cravings and synthetic opioids while minimizing withdrawal symptoms. But buprenorphine is less potent and less likely to lead to a fatal overdose than methadone. California doctors have more flexibility to prescribe it than with methadone or naltrexone, another medication used to treat addiction.
In 2002, the Food and Drug Administration approved buprenorphine for the treatment of opioid dependence. In 2015, Medi-Cal removed a rule requiring physicians to obtain prior authorization from each patient. This requirement was an additional barrier for many physicians who had to obtain a federal dispensation prior to treating patients with the drug – a process that requires eight hours of training.
Waiver is always required. But since 2017, the state's California Drug Treatment Expansion (MAT) project has trained doctors to obtain it.
Once they have obtained the waiver, doctors can prescribe buprenorphine in various settings, including primary health care offices, community hospitals and correctional facilities. On the other hand, methadone can only be administered through federally approved opioid treatment programs.
A bill recently introduced in Congress would eliminate the federal waiver requirement for buprenorphine, which would give physicians even more flexibility.
California's MAT expansion program also funds current state-wide radio and television advertising that encourages opioid addicts to seek treatment with the help of drugs. The program sponsors a website, choosemat.org, which directs people to treatment.
"When you can have someone on [MAT]It's obvious that it's working really well, "said Brian Hurley, director of addiction medicine for the Los Angeles County Department of Health Services. But to start is the biggest obstacle. "
The MAT Expansion Initiative, launched with two federal grants totaling $ 264 million, helps cover the cost of treatment not only for Medi-Cal enrollees, but also for those without insurance and those with insurance. private who will not pay for the treatment.
Marlies Perez, chief of the Addiction Compliance Division at the California Department of Health Services, said that an extension of methadone treatment programs was underway and that she hoped the number Medi-Cal's methadone claims would increase.
The MAT program is also seeking to expand treatment options for Native American and Native Alaskan states, who have been disproportionately hit by the opioid epidemic, said Perez.
In 2017, the rate of opioid overdose deaths in California was 5.3 deaths per 100,000 population – only about a third of the US rate. However, some rural counties in northern California, including Modoc, Humboldt, Mendocino and Lake, had rates three or four times higher than the average for the entire state.
Despite improving access to buprenorphine, a lot of work remains to be done, according to Perez. "I do not want to diminish the fact that too many people are dying of a treatable disease," she said.
METHODOLOGY
The data we have used, from the California Department of Health Services, indicates the number of patients for whom Medi-Cal claims have been submitted for buprenorphine and methadone.
The ministry counts the number of claimants for these drugs per quarter. Our badysis began in the fourth quarter of 2014 and, for buprenorphine, was completed in the third quarter of 2018. For methadone, available data only cover the end of 2017.
For each quarter, KHN calculated the rate of individuals receiving methadone and buprenorphine per 10,000 enrolled in the Medi-Cal program. This allowed us to take over Medicaid's expansion into the affordable healthcare law, which increased Medi-Cal's workforce from 8.6 million at the end of 2013 to around 13 million. as of September 2018.
Quarterly totals are likely undercoverage because the DHCS excludes drug-related data in any county where the number of people receiving this drug is less than or equal to 10.
This KHN story was first published on California Healthline, a service of the California Health Care Foundation.
|
|
[ad_2]
Source link
