ArticleDrug and alcohol dependence reports2026
Relationship between extended-release buprenorphine adherence and reduced risk of return to use in patients with opioid use disorder: A retrospective claims data analysis.
Article in Drug and alcohol dependence reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To evaluate the association between adherence to monthly extended-release buprenorphine (BUP-XR) and reducing the risk of return to use among patients with opioid use disorder (OUD). Methods: This retrospective claims analysis included adult patients (age≥18 years) initiating monthly BUP-XR between 3/1/2019-12/31/2022 (index date=earliest BUP-XR claim date) in the Merative™ MarketScan® Commercial/Medicare/Medicaid Databases. Patients had continuous enrollment with medical/pharmacy/behavioral health benefits for 12 months pre-index (baseline period) and 12 months post-index (follow-up period). Patients were categorized to four mutually-exclusive groups: Group 1 (adherence [proportion of days covered; PDC≥0.8] to BUP-XR treatment); Group 2 (adherence to overall MOUD but BUP-XR PDC<0.8); Group 3 (non-adherence to overall MOUD and primarily treated with BUP-XR); Group 4 (non-adherence to overall MOUD and not primarily treated with BUP-XR). Descriptive and adjusted analyses compared the prevalence of return to use during follow-up for Group 1 (reference) to other groups. Results: Of 3400 patients, 19.8% had adherence to BUP-XR (Group 1) during the 12-month follow-up (20.9% in Group 2, 39.9% in Group 3, and 19.4% in Group 4). Compared to patients with BUP-XR adherence (Group 1), patients not meeting adherence criteria with BUP-XR were significantly more likely to return to use (adjusted odds ratios of 3.49 for Group 2, 3.30 for Group 3, and 8.08 for Group 4; all p < 0.001), including Group 2 patients who had BUP-XR PDC< 0.8 but had adherence to overall MOUD. Conclusion: Adherence to monthly BUP-XR 100 mg or 300 mg in the 12 months following treatment initiation was associated with reduced odds of return to use compared to less consistent use of BUP-XR and continued adherence to other MOUD.
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