BACKGROUND: Compared to non-veterans, veterans are disproportionately diagnosed with opioid dependence. Sublingual buprenorphine provides greater access to opioid agonist therapy. To understand the diffusion of this innovative treatment within a large healthcare system, we describe the introduction of buprenorphine within the Veterans Health Administration (VHA) during the first 3 years of its approval as a VHA non-formulary medication. METHODS: Using VHA pharmacy databases, we examined the number of physicians who have prescribed buprenorphine and the number of veterans who have received office-based buprenorphine within VHA veterans integrated service networks (VISN) from fiscal years (FY) 2003 through FY 2005 (October 2002 through September 2005). RESULTS: From FY2003 through FY2005 the number of veterans with opioid dependence increased from 25,031 to 26,859 (>7.3%) and the number of veterans prescribed office-based buprenorphine increased from 53 to 739. During this interval, 16 of 21 VISNs had prescribed buprenorphine. In FY2005, two VISNs accounted for 31% of buprenorphine prescriptions. The number of buprenorphine prescriptions varied widely by VISN, but increased from 212 to 7076 from FY2003 through FY2005. During this interval, prescriptions per patient increased from 4.0 to 9.6 and physicians prescribing buprenorphine increased from 14 to 170. The ratio of patients prescribed buprenorphine to providers prescribing buprenorphine increased from 3.8 to 4.3 with an average increase of 15.1-41.6 of prescriptions per provider. CONCLUSIONS: VHA increased, but not uniformly, the non-formulary use of office-based buprenorphine during the first 3 years of availability.
BACKGROUND: Compared to non-veterans, veterans are disproportionately diagnosed with opioid dependence. Sublingual buprenorphine provides greater access to opioid agonist therapy. To understand the diffusion of this innovative treatment within a large healthcare system, we describe the introduction of buprenorphine within the Veterans Health Administration (VHA) during the first 3 years of its approval as a VHA non-formulary medication. METHODS: Using VHA pharmacy databases, we examined the number of physicians who have prescribed buprenorphine and the number of veterans who have received office-based buprenorphine within VHA veterans integrated service networks (VISN) from fiscal years (FY) 2003 through FY 2005 (October 2002 through September 2005). RESULTS: From FY2003 through FY2005 the number of veterans with opioid dependence increased from 25,031 to 26,859 (>7.3%) and the number of veterans prescribed office-based buprenorphine increased from 53 to 739. During this interval, 16 of 21 VISNs had prescribed buprenorphine. In FY2005, two VISNs accounted for 31% of buprenorphine prescriptions. The number of buprenorphine prescriptions varied widely by VISN, but increased from 212 to 7076 from FY2003 through FY2005. During this interval, prescriptions per patient increased from 4.0 to 9.6 and physicians prescribing buprenorphine increased from 14 to 170. The ratio of patients prescribed buprenorphine to providers prescribing buprenorphine increased from 3.8 to 4.3 with an average increase of 15.1-41.6 of prescriptions per provider. CONCLUSIONS: VHA increased, but not uniformly, the non-formulary use of office-based buprenorphine during the first 3 years of availability.
Authors: Adam J Gordon; Hillary V Kunins; Darius A Rastegar; Jeanette M Tetrault; Alexander Y Walley Journal: J Gen Intern Med Date: 2010-08-10 Impact factor: 5.128
Authors: Chiao-Wen Lan; David A Fiellin; Declan T Barry; Kendall J Bryant; Adam J Gordon; E Jennifer Edelman; Julie R Gaither; Stephen A Maisto; Brandon D L Marshall Journal: Am J Addict Date: 2015-12-22
Authors: Kevin L Kraemer; Kathleen A McGinnis; David A Fiellin; Melissa Skanderson; Adam J Gordon; Jonathan Robbins; Susan Zickmund; Kendall Bryant; P Todd Korthuis Journal: J Subst Abuse Treat Date: 2019-05-07
Authors: Carrie M Farmer; Dawn Lindsay; Jessica Williams; Amanda Ayers; James Schuster; Alyssa Cilia; Michael T Flaherty; Todd Mandell; Adam J Gordon; Bradley D Stein Journal: Subst Abus Date: 2015-04-06 Impact factor: 3.716
Authors: Jessica J Wyse; Adam J Gordon; Steven K Dobscha; Benjamin J Morasco; Elizabeth Tiffany; Karen Drexler; Friedhelm Sandbrink; Travis I Lovejoy Journal: Subst Abus Date: 2018 Impact factor: 3.716
Authors: Bradley D Stein; Rosalie Liccardo Pacula; Adam J Gordon; Rachel M Burns; Douglas L Leslie; Mark J Sorbero; Sebastian Bauhoff; Todd W Mandell; Andrew W Dick Journal: Milbank Q Date: 2015-09 Impact factor: 4.911
Authors: Andrew W Dick; Rosalie L Pacula; Adam J Gordon; Mark Sorbero; Rachel M Burns; Douglas Leslie; Bradley D Stein Journal: Health Aff (Millwood) Date: 2015-06 Impact factor: 6.301
Authors: Bradley D Stein; Adam J Gordon; Andrew W Dick; Rachel M Burns; Rosalie Liccardo Pacula; Carrie M Farmer; Douglas L Leslie; Mark Sorbero Journal: J Subst Abuse Treat Date: 2014-08-02