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5 facts about Medicaid spending to treat opioid use disorder: expansion states have increased spending significantly.

Medicaid spending on prescriptions for the treatment of opioid use disorder has soared in recent years, particularly in Medicaid expansion states. But proposed cuts in federal Medicaid spending could leave states with high overdose-related mortality rates in a particularly precarious position, according to a report recently released by the Urban Institute's Health Policy Center.

1 Medicaid-covered spending on prescriptions for opioid use disorder (OUD) treatment in the United States increased by nearly 136% from 2011-2016, an average of 19% per year, climbing from $394.2 million in 2011 to $929.9 million by 2016.

2 While most Medicaid-covered spending on OUD prescriptions was for buprenorphine (reaching $753.9 million in 2016 alone), spending on naltrexone and naloxone saw greater increases during the period covered in the Urban Institute report. Spending on naltrexone climbed from $13.3 million to $156.3 million, while spending on naloxone soared from $20,000 to $19.7 million, coinciding with the release of its nasal spray form.

3 Among the key states with high overdose rates that were studied for the report, Ohio spent the most in 2016 with an outlay of $123.6 million. By comparison, Ohio had only spent about $20 million in 2011.

4 Medicaid expansion states with high drug overdose mortality rates have been particularly aggressive in increasing their Medicaid spending on buprenorphine for OUD, as well as naltrexone and naloxone. Overall, Medicaid spending on OUD treatment medications has increased more in states that have expanded Medicaid, leading Urban Institute researchers to question whether and how the 19 nonexpansion states are financing treatment for low-income individuals.

5 States with the highest drug overdose mortality rates could be the hardest hit by proposed cuts to federal Medicaid spending. The Urban Institute says larger increases in Medicaid spending likely will be needed to meet future demand for OUD treatment, and that with current levels of treatment already not meeting today's demand, decreasing treatment and access to overdose-reversal medications could further increase mortality rates, particularly in states with already-high rates.


The full Urban Institute Health Policy Center report can be viewed at:

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Title Annotation:NEED TO KNOW
Author:Valentino, Tom
Publication:Behavioral Healthcare
Date:Jun 22, 2017
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