Factors Affecting Buprenorphine Utilization and Spending in Medicaid, 2002-2018

Brand-name buprenorphine-naloxone (Suboxone) formulations accounted for 2.7 times more prescriptions and 4.4 times higher spending than all other buprenorphine formulations combined in Medicaid from 2002-2018, with various market and regulatory factors delaying market entry of generic versions by 6-9 years. Earlier availability of affordable generic alternatives could have expanded access to buprenorphine treatment during the opioid crisis and reduced Medicaid expenditures.