Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panel
Objective: Less than one-in-four patients with opioid use disorder receive opioid agonist treatment. This is in part due to the fact that less than 60 % of pharmacies stock and dispense buprenorphine products for the treatment of opioid use disorder (OUD). Pharmacies do not stock for many reasons bu...
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Elsevier
2025-09-01
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| Series: | Drug and Alcohol Dependence Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772724625000435 |
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| author | Tyler J. Varisco Douglas Thornton Taha Hussain Hannah Fish Joshua Bolin David Dadiomov Ekere J. Essien Matthew A. Wanat Diane Ginsburg Jeanne Waggener Jeffrey P. Bratberg Bethany DiPaula Lucas G. Hill |
| author_facet | Tyler J. Varisco Douglas Thornton Taha Hussain Hannah Fish Joshua Bolin David Dadiomov Ekere J. Essien Matthew A. Wanat Diane Ginsburg Jeanne Waggener Jeffrey P. Bratberg Bethany DiPaula Lucas G. Hill |
| author_sort | Tyler J. Varisco |
| collection | DOAJ |
| description | Objective: Less than one-in-four patients with opioid use disorder receive opioid agonist treatment. This is in part due to the fact that less than 60 % of pharmacies stock and dispense buprenorphine products for the treatment of opioid use disorder (OUD). Pharmacies do not stock for many reasons but wholesale distribution remains a major barrier to buprenorphine availability. The objective of this study was to create consensus recommendations to improve wholesale distribution of buprenorphine for the treatment OUD in community pharmacies. Methods: This study involved a qualitative elicitation study, grounded in the theory of planned behavior, with seven-focus groups and 46 total pharmacists in Texas, California, and West Virginia. Results of the reflexive thematic analysis were used to create a vignette describing pharmacy-based barriers to buprenorphine supply. Non-legislative recommendations to improve buprenorphine purchase were created through a four-round Delphi study with 22 experts in psychiatry, pharmacy practice, drug distribution, and drug-policy and public comment review between June 2022 and September 2024. Results: The elicitation study demonstrated that distributor thresholds led to buprenorphine rationing, care interruptions, payer limitations, and fear of enforcement in community pharmacies. The expert panel recommended six, consensus actions that pharmacists, DEA and distributors could take to avoid further interruptions in buprenorphine availability. Conclusion: DEA and distributors can act now, without congressional intervention, to ensure that the terms of the opioid injunctive relief agreement do not impede the ability of pharmacists to provide care to persons with OUD. |
| format | Article |
| id | doaj-art-c521cea1c2fd47fab3d38cec44647e98 |
| institution | Matheson Library |
| issn | 2772-7246 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj-art-c521cea1c2fd47fab3d38cec44647e982025-07-19T04:39:29ZengElsevierDrug and Alcohol Dependence Reports2772-72462025-09-0116100360Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panelTyler J. Varisco0Douglas Thornton1Taha Hussain2Hannah Fish3Joshua Bolin4David Dadiomov5Ekere J. Essien6Matthew A. Wanat7Diane Ginsburg8Jeanne Waggener9Jeffrey P. Bratberg10Bethany DiPaula11Lucas G. Hill12Pharmacy Addictions Research and Medicine Program, University of Texas at Austin College of Pharmacy, US; Health Outcomes Division, University of Texas at Austin College of Pharmacy, US; Correspondence to: University of Houston College of Pharmacy, 4349 Martin Luther King Blvd, Houston, TX 77204, USA.The Prescription Drug Misuse Education and Research Center, University of Houston College of Pharmacy, USA; Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, USAThe Prescription Drug Misuse Education and Research Center, University of Houston College of Pharmacy, USAThe National Community Pharmacists Association, USAThe National Association of Boards of Pharmacy, USATitus Family Department of Clinical Pharmacy, The University of Southern California College of Pharmacy, USADepartment of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, USAThe Prescription Drug Misuse Education and Research Center, University of Houston College of Pharmacy, USA; Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, USADivision of Pharmacy Practice, University of Texas at Austin, College of Pharmacy, USAConsulting, LLCThe University of Rhode Island College of Pharmacy, USAThe University of Maryland College of Pharmacy, USADepartment of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, USAObjective: Less than one-in-four patients with opioid use disorder receive opioid agonist treatment. This is in part due to the fact that less than 60 % of pharmacies stock and dispense buprenorphine products for the treatment of opioid use disorder (OUD). Pharmacies do not stock for many reasons but wholesale distribution remains a major barrier to buprenorphine availability. The objective of this study was to create consensus recommendations to improve wholesale distribution of buprenorphine for the treatment OUD in community pharmacies. Methods: This study involved a qualitative elicitation study, grounded in the theory of planned behavior, with seven-focus groups and 46 total pharmacists in Texas, California, and West Virginia. Results of the reflexive thematic analysis were used to create a vignette describing pharmacy-based barriers to buprenorphine supply. Non-legislative recommendations to improve buprenorphine purchase were created through a four-round Delphi study with 22 experts in psychiatry, pharmacy practice, drug distribution, and drug-policy and public comment review between June 2022 and September 2024. Results: The elicitation study demonstrated that distributor thresholds led to buprenorphine rationing, care interruptions, payer limitations, and fear of enforcement in community pharmacies. The expert panel recommended six, consensus actions that pharmacists, DEA and distributors could take to avoid further interruptions in buprenorphine availability. Conclusion: DEA and distributors can act now, without congressional intervention, to ensure that the terms of the opioid injunctive relief agreement do not impede the ability of pharmacists to provide care to persons with OUD.http://www.sciencedirect.com/science/article/pii/S2772724625000435PharmacistsBuprenorphineMedication systemsDrug and narcotic control |
| spellingShingle | Tyler J. Varisco Douglas Thornton Taha Hussain Hannah Fish Joshua Bolin David Dadiomov Ekere J. Essien Matthew A. Wanat Diane Ginsburg Jeanne Waggener Jeffrey P. Bratberg Bethany DiPaula Lucas G. Hill Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panel Drug and Alcohol Dependence Reports Pharmacists Buprenorphine Medication systems Drug and narcotic control |
| title | Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panel |
| title_full | Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panel |
| title_fullStr | Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panel |
| title_full_unstemmed | Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panel |
| title_short | Addressing wholesale distributor barriers to buprenorphine access: Consensus recommendations from the PhARM-OUD expert panel |
| title_sort | addressing wholesale distributor barriers to buprenorphine access consensus recommendations from the pharm oud expert panel |
| topic | Pharmacists Buprenorphine Medication systems Drug and narcotic control |
| url | http://www.sciencedirect.com/science/article/pii/S2772724625000435 |
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