The Impact of Prior Authorization on Buprenorphine Dose, Relapse Rates, and Cost for Massachusetts Medicaid Beneficiaries with Opioid Dependence

Wednesday, July 9, 2014

This article highlights the evaluation of a buprenorphine dose-based prior authorization policy developed by MassHealth, the Massachusetts Medicaid program, in consultation with UMass Medical School. The evaluation suggests the policy may be a model for other states that are concerned about diversion of buprenorphine among individuals with opioid dependence.

Prior authorization policies strategically targeted by dose level appear to successfully reduce use of higher than recommended buprenorphine doses. Savings from these policies are modest and may be accompanied by brief increases in relapse rates. Lower doses may decrease diversion of buprenorphine.