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When Medicare expanded coverage for methadone, more people used this treatment for opioid use disorder, a new study shows.
Use rose sharply but did not displace other opioid treatments such as buprenorphine, according to researchers.
Much of the rise in methadone use was among Medicare Advantage enrollees under age 65. It was especially true among those who qualified for both Medicare and Medicaid.
“These new policies represent an important step in increasing access to medication treatment for opioid use disorder for Medicare beneficiaries,” said lead author Erin Taylor, a senior policy researcher at RAND Corporation, a nonprofit research organization.
To study this, the researchers analyzed encounter data and pharmacy records covering nearly 10 million people enrolled in Medicare Advantage health plans.
About half of Medicare recipients are enrolled in Medicare Advantage. It typically provides more benefits to enrollees than traditional Medicare.
Changes to policies and coverage appeared to be associated with increasing rates of methadone use in each quarter beginning in January 2020, according to the study.
That was when Medicare expanded payment for treating opioid use disorder with methadone. Rules adopted in March 2020 because of the COVID-19 pandemic also made it easier to access the medication.
Researchers found that the rate of buprenorphine use also increased among Medicare Advantage enrollees during the study period.
“We found a relatively steady rate of increase in buprenorphine prescribing, which showed no obvious changes after coverage for methadone began,” Taylor said in a RAND news release. “This suggests that there was little substituting of methadone for buprenorphine.”
It wasn't clear whether some Medicare Advantage enrollees who received methadone had previously been receiving it using different payment methods, such as block grant programs.
Typically, methadone is dispensed through federally certified and licensed treatment programs. Other opioid use disorder medications, buprenorphine and naltrexone, can be taken at home.
More than 80,000 Americans died from opioid overdoses in 2021, according to the study.
Researchers said future work should explore whether there has been increased methadone use in traditional fee-for-service Medicare, as well as age differences among Medicare Advantage patients.
The findings were published May 19 in JAMA Network Open. Support for the study was provided by the U.S. National Institute on Aging.
The U.S. Centers for Disease Control and Prevention has more on opioid use disorder.
SOURCE: RAND Corporation, news release, May 19, 2023
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