37% Of First Buprenorphine Prescriptions For OUD Went Unfilled In 2024

People whose prescriptions were abandoned were younger, with an average age of 54.3 years compared with 57.4 years among those whose prescriptions were filled. Hispanic consumers represented 10.6% of the group with abandoned prescriptions compared with 4.8% of the group whose prescriptions were filled. Commercial insurance members represented 51.8% of the abandonment group compared with 29.4% of the group whose prescriptions were filled. Average pharmacy deductibles were also higher among people whose prescriptions were abandoned, at $483.80 compared with $296.40.

Researchers compared adults whose first buprenorphine prescription was dispensed within 30 days with those whose prescription was abandoned. A prescription was considered abandoned when there was no insurance claim showing that it had been dispensed within 30 days, including prescriptions that consumers did not fill and those rejected by an insurer or pharmacy. People who filled their prescriptions were more likely to have a documented OUD diagnosis or overdose, other substance use disorder diagnosis, or mental health diagnosis during the previous six months.

The study used deidentified electronic health records linked with insurance claims from the Optum Labs Data Warehouse. Researchers identified 1,428 adults with commercial insurance or Medicare Advantage who received their first recorded buprenorphine prescription for OUD between January 1, 2020, and September 25, 2024. Participants were required to have medical and pharmacy coverage for at least 180 days before the prescription and at least 30 days afterward.

The researchers concluded that the growing rate of abandoned buprenorphine prescriptions represents a missed opportunity for OUD treatment initiation and engagement. They said higher pharmacy deductibles may be an important factor and called for further study of insurance benefit design, including prior authorization, quantity limits, and cost sharing. They also cited potential language and pharmacy access barriers as possible contributors to the differences among Hispanic consumers. The findings may not apply beyond commercially insured and Medicare Advantage populations, and the data could not distinguish prescriptions consumers chose not to fill from those rejected by pharmacies or insurers.

These findings were presented in Abandonment of Prescribed Buprenorphine for Opioid Use Disorder, 2020-2024 by Xinyi Jiang, Ph.D., MS; Kun Zhang, Ph.D.; Yijie Chen, Ph.D.; Yi-Wen Shih, Ph.D., M.D.; Nisha Nataraj, Ph.D.; and Gery P. Guy Jr., Ph.D., MPH. The goal was to examine trends in abandonment of newly prescribed buprenorphine and characteristics associated with abandonment among adults from 2020 through 2024.

The full text of Abandonment of Prescribed Buprenorphine for Opioid Use Disorder, 2020-2024 was published on August 4, 2026, by JAMA Network Open. A free copy is available (accessed August 12, 2026).

For more information, contact: Xinyi Jiang, Ph.D., MS, Communications for the Division of Overdose Prevention, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30329; 800-232-4636; Email: CDCInfo@cdc.gov; Website: https://www.cdc.gov/