Users of retail medications for opioid use disorders faced high out-of-pocket prescription spending in 2011-2017

Introduction: High out-of-pocket spending has been a barrier to treatment for the estimated 2.0 million Americans suffering from opioid use disorders (OUD). This paper provides national estimates of financial costs faced by the population receiving retail medications for OUD (MOUD). Methods: We used pooled annual data from the 2011-2017 Medical Expenditure Panel Survey (MEPS), a nationally representative sample of the civilian noninstitutionalized population in the United States. The sample includes individuals who reported filling a retail prescription for buprenorphine or naltrexone, the two most common medications available from retail pharmacies to treat OUD. The main outcome is out-of-pocket spending of retail MOUD prescriptions per fill and per person. Results: Patients with retail MOUD prescriptions spent 3.4 times more out-of-pocket for prescriptions on average than the rest of the U.S. population, with 18.8% of this population paying entirely out-of-pocket for their MOUD prescriptions. Insurance coverage is associated with reduced annual out-of-pocket MOUD expenditures between $316 and $328 per year. Conclusions: Future policies that expand insurance and address out-of-pocket spending on MOUD could increase access to medications among individuals with OUD.

Automated summary

Patients purchasing retail MOUD prescriptions spent 3.4 times more out-of-pocket on average compared to the rest of the U.S. population, with nearly one-fifth of this population entirely self-paying for their prescriptions. Insurance coverage was associated with significantly reduced annual out-of-pocket MOUD expenditures.