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Disclosures: Nguyen and Stein report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
January 26, 2021
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Number of filled prescriptions dropped ‘considerably’ in early days of COVID-19 pandemic

Disclosures: Nguyen and Stein report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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The number of individuals filling prescriptions for all medications decreased “considerably” in the early days of the COVID-19 pandemic, researchers wrote in JAMA Internal Medicine.

However, the number of individuals who filled prescriptions for buprenorphine “plateaued” but did not “decrease” during this period, they added.

Prescription
The early days of the pandemic were associated with a sudden decline in all filled prescriptions and a stabilizing of prescriptions for some buprenorphine products, researchers wrote in JAMA Internal Medicine. Photo source: Adobe Stock.

“Americans with opioid use disorder are a vulnerable population during the COVID-19 pandemic, with recent data suggesting a substantial increase in overdoses,” Thuy D. Nguyen, PhD, a research assistant professor of health management and policy at the University of Michigan School of Public Health, told Healio Primary Care. “We wanted to understand how the pandemic was affecting access to one of the most effective treatments [for opioid use disorder] in order to inform practitioners and policy makers of this rapidly evolving situation.”

Thuy D. Nugyen

Nguyen and colleagues analyzed retail pharmacy claims for the period between May 1, 2019, and June 28, 2020, from a United States database containing 92% of retail pharmacy claims. They excluded the week of March 8 to March 15 because it was the week before the Substance Abuse and Mental Health Services Administration and Drug Enforcement Administration approved the use of telehealth for buprenorphine prescribing, they wrote. The researchers also examined trends of total sales from U.S. retail pharmacies and sales of buprenorphine products with an FDA–approved indication for opioid use disorder treatment at various intervals during the study period.

The researchers found that from May 2019 to March 2020, there was a 26.01% increase in the number of individuals who filled buprenorphine product prescriptions and an 8.78% increase in those people who filled prescriptions of any type.

“This suggests that recent federal and local efforts to expand buprenorphine access to millions of individuals with opioid use disorder, such as the 2016 Comprehensive Addiction and Recovery Act, which allowed nurse practitioners and physician assistants to obtain a waiver and prescribe buprenorphine, were working,” Nguyen said.

However, the weekly growth rate in prescription fills for buprenorphine declined between the pre-pandemic (May 1, 2019, to March 15, 2020) and pandemic (March 16, 2020, to June 28, 2020) periods by 0.50% (95% CI, 0.84% to 0.15%).

The researchers also used a quasiexperimental interrupted time series analysis to determine if there was a change in the level or rate of growth (slope) of all filled prescriptions between the pre-pandemic and pandemic periods. They reported that the pandemic period was associated with an “abrupt” decline in levels (–5.03 million patients who filled any prescription; 95% CI, –6.85 million to –3.2 million) and growth rate (–0.57%; 95% CI, –1.01% to –0.14%) of all prescriptions. Put another way, the pandemic period was associated with a 10.8% decline in any prescription and a 1.25% decline in prescriptions for buprenorphine. These patterns contrasted with those of buprenorphine product prescriptions, according to the researchers.

“Since the pandemic, the number of individuals filling buprenorphine prescriptions essentially plateaued but did not decrease in the way filled prescriptions for all medications did, suggesting some of the responses to the pandemic, like relaxing telehealth rules, worked," Bradley Stein, PhD, MD, MPH, director of the Rand Corporation’s Opioid Policies, Tools, and Information Center and a study co-author, told Healio Primary Care.

Bradley Stein

"But more needs to be done to address increasing drug overdoses during the public health emergency,” he added.